What are the operative mortality and long-term survival rates following surgical treatment of left main coronary artery stenosis?
Surgical treatment of left main coronary artery stenosis has an acceptable overall operative mortality of 6.4% and provides good long-term survival, particularly in stable patients and those receiving complete revascularization.
Abstract Catheterization morbidity, results of medical treatment, and operative morbidity and mortality in patients with left main coronary artery stenosis (LCA) are higher than in patients with other coronary atherosclerotic lesions, occurring in combination or alone. Patients with LCA stenosis have a wide variety of clinical manifestations and range from “asymptomatic” patients with only positive exercise tests to critically ill, unstable patients requiring emergency angiography and operation. Experience with the surgical treatment of LCA stenosis in 141 patients at the Peter Bent Brigham Hospital from 1970–1977 is reviewed. Operative mortality rates were 10% (5/49) in unstable patients, 4% (4/92) in stable patients, and 6.4% (9/141) overall. Actuarial survival up to 90 months was better in stable than unstable patients, in patients who were completely rather than incompletely revascularized, and in patients in whom only LCA stenosis existed and was bypassed. Prospective studies of medical and surgical treatment support the concept that patients with LCA disease should be treated with coronary bypass surgery .
Cohn et al. (Wed,) studied this question.