Complete occlusion of the left main coronary artery: report of three surgical cases and review of the literature

The Thoracic and Cardiovascular Surgeon
M KawasujiH G Borst

Abstract

Out of 75 consecutive patients with left main coronary artery (LMCA) obstruction who underwent coronary revascularization between January and October 1980, 3 patients had total occlusion of the LMCA. All 3 patients were suffering from severe angina pectoris preoperatively. On cardiac catheterization they had shown extensive collaterals from the right coronary artery and relatively well-preserved left ventricular function. In addition to intercoronary anastomoses a relatively high extracoronary collateral blood flow was measured at operation. Postoperatively the 3 patients remained free of angina (class I NYHA) at 5, 20 and 50 months after uneventful surgery. It is concluded that patients with adequate intercoronary and extracoronary collaterals may well survive complete occlusion of the LMCA. Surgery appears to carry a low risk no greater than that involved in conservative treatment of LMCA stenosis and the postoperative clinical status of the patients continues to be satisfactory.

Citations

Jun 27, 2006·Scandinavian Cardiovascular Journal : SCJ·Anders JönssonTorbjörn Ivert
Jul 1, 1983·American Heart Journal·M T Bink-BoelkensR A Hardjowijono
Jan 4, 2020·Developmental Medicine and Child Neurology·Emma Macdonald-LaursP Ian Andrews

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