Clinical experience of coronary artery bypass graft on the left main coronary stenosis in 225 cases / 中华胸心血管外科杂志

ABSTRACT

Objective: To study the efficacy and clinical experience of surgical treatment in the patients with left main coronary artery stenosis. Methods: Two hundred and twenty-five patients with left main stenosis (LMS) underwent coronary artery bypass graft (CABG) between January 1999 and June 2003. The average age was 63.4 years. The left ventricular ejection fraction was ≤30% in 11 patients. Emergency surgical revascularization was performed in 6 patients because of hemodynamic instability in whom 3 were treated with intraaortic balloon pump (IABP) before surgery. Seventy-six patients underwent coronary artery revascularization with conventional cardiopulmonary bypass, 149 without pump (OPCAB), and 5 patients were converted to CPB. Thirteen patients accepted total arterial revascularization and 3 total venous conduits. Results: The mean preoperative stay was 2.3 days and number of distal anastomoses was 2.95/pt. There were 13 postoperative deaths with a mortality of 5.78%. Conclusion: The presence of left main stenosis is an independent predictor of postoperative mortality after coronary bypass grafting. CABG at presents is the first choice for such patient and is a safe and effective method.