Key result
Coronary revascularization resolves angina and maintains survival in complete LMCA occlusion.
Why the study?
Does coronary revascularization improve symptoms and survival in patients with complete occlusion of the left main coronary artery?
Case Report (n=3)
Does coronary revascularization improve symptoms and survival in patients with complete occlusion of the left main coronary artery?
Coronary revascularization can be safely performed and provides satisfactory symptomatic relief in patients with complete LMCA occlusion who have adequate collateral circulation.
Supports revascularization feasibility in selected collateralized cases; leaves open broader efficacy and survival benefit without controlled data.
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.
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Kawasuji et al. (1981) conducted a case report in Total occlusion of the left main coronary artery (n=3). Coronary revascularization was evaluated on Survival and freedom from angina. Coronary revascularization in three patients with complete occlusion of the left main coronary artery resulted in survival and freedom from angina at 5 to 50 months postoperatively.