PROGNOSIS OF CORONARY-BYPASS SURGERY IN P ATIENTS WITH ISCHEMIC-HEART-DISEASE AND INVOLVEMENT OF THE LEFT CORONARY-ARTERY TRUNK

Of 426 patients in whom coronary artery bypass grafting was performed 134 had 50 - 100% stenoses of the left main coronary artery and 292 ha d not. Aorto-coronary venous grafts were used in 56% and internal mamm ary grafts - in 44% of patients. Perioperative mortality was insignifi cantly higher in patients with lef main stenoses (5,2%) compared to pa tients without left main involvement (3,7%). Main cause of death was a cute heart failure. Initial clinical state and especially presence of depressed left ventricular function affected operative results. Heart failure increased risk of death in both groups but this increase was s ignificant only in patients with left main stenosis. In a year after o peration 20% of patients had angina. By this time 28% of autovenous an d 5% of autoarterial shunts had been occluded. Number of occlusions, l evels of lipids, frequency of angina recurrences and severity of angin a were similar in both groups. In 3 years angina recurred in 26% of pa tients in each of the groups while severe angina of functional class I V recurred more frequently in patients with left main stenoses.