URGENT ROTATIONAL ABLATION OF A PARTIALLY PROTECTED, TOTALLY OCCLUDEDLEFT MAIN CORONARY-ARTERY

Coronary artery by-pass surgery (CABG) is considered the treatment of choice for patients with significant stenosis of the left main coronar y artery. However, with reduction of the flow post-CABG, the left main may become totally occluded. This may become important once graft fai lure occurs. This case describes a patient who had by-pass surgery for critical left main stenosis and was re-admitted four months later wit h graft failure and total occlusion of his left main, necessitating ur gent rotational ablation of this partially protected, totally occluded left main coronary artery. This case raises the question of ''prophyl actic'' left main angioplasty soon after surgery for critical left mai n stenosis, in order to eliminate the need for redo operation once gra ft failure occurs. (C) 1996 Wiley-Liss, Inc.