M. Schmuziger et Jt. Christenson, SURGICAL PATCH OSTIUMPLASTY OF THE LEFT MAIN CORONARY-ARTERY, The thoracic and cardiovascular surgeon, 44(1), 1996, pp. 27-30
The prevalence of ostium stenosis of the left main coronary artery, is
olated or not, varies from 0.1% to 1.9%, Could ostium angioplasty and
reconstruction of the proximal left main coronary artery be a real sur
gical alternative for this condition? What are the risks and which are
the results? In the present study we have reviewed our experience of
10 patients undergoing ostium angioplasty (mean age 55 years; male/fem
ale 6/4). Four of the operations were reoperations. There was only one
hospital mortality and the incidence of postoperative morbidity was l
ow. On ly one patient (a reoperation) required blood transfusion to co
mpensate for a minor diffuse postoperative bleeding, All hospital surv
ivors were followed up for an average period of 7 months (range 3-56).
Eight of the 9 surviving patients were in perfect clinical condition
at the end of the follow-up, only one was in NYHA class II and CCS cla
ss 2, The mean LVEF at the end of the follow-up was normal and the mea
n ergometry capacity was 159+/-18W. Follow-up coronary angiography sho
wed no tendency to restenosis in any of the cases. Ostium patch angiop
lasty offers several advantages over conventional coronary artery bypa
ss grafting. Reoperation, preoperative unstable angina, or poor left-v
entricular function pose no contraindications for ostium angioplasty,
Presence of aortic and/or ostium calcifications, however, constitutes
an absolute contraindication. Ostium patch angioplasty of the proximal
left main coronary artery should be considered a surgical alternative
in selected patients.