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. 1976 Oct;31(5):522–526. doi: 10.1136/thx.31.5.522

Left main stem coronary artery disease. Retrospective review of 26 patients treated surgically or medically.

L J Day, H O Vallin, E Sowton
PMCID: PMC470469  PMID: 1087051

Abstract

The clinical, angiographic, exercise testing, operative, and follow-up data of 26 patients found at angiography to have left main stem coronary artery stenosis, defined as a reduction in the lumen diameter of 50% or more, are reviewed. There was a high incidence of significant proximal stenosis in the branches of the left main stem. No clinical features were found to distinguish patients with left main stem stenosis. All patients were considered for saphenous vein bypass grafting, selection being based upon the severity of symptoms, left ventricular function, and suitability of the coronary vessels for grafting. Two patients died within 24 hours of coronary angiography. Nine patients were operated on with no mortality. There has been one late cardiac death during a mean follow-up time of 13 months. All patients were symptomatically improved with a significant (P less than 0-01) increase in exercise ability postoperatively. Fifteen patients were not operated on. Six of these patients were regarded as operable but surgery was deferred; five have died at a mean time of 7-2 months. Five of the nine patients regarded as inoperable have died at a mean follow-up time of 14-8 months. The five non-surgical survivors remain symptomatic with no significant change in exercise ability. Recently reported surgical and medical series of patients with left main stem stenosis are reviewed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Balcon R., Banim S. O., Donaldson R. M. Proceedings: Experience with left main stem coronary stenosis. Br Heart J. 1975 May;37(5):551–551. [PubMed] [Google Scholar]
  2. Balcon R., Leaver D., Ross D., Ross K., Sowton E. Clinical evaluation of internal mammary-artery implantation. Lancet. 1970 Feb 28;1(7644):440–443. doi: 10.1016/s0140-6736(70)90832-9. [DOI] [PubMed] [Google Scholar]
  3. Bruschke A. V., Proudfit W. L., Sones F. M., Jr Progress study of 590 consecutive nonsurgical cases of coronary disease followed 5-9 years. I. Arterographic correlations. Circulation. 1973 Jun;47(6):1147–1153. doi: 10.1161/01.cir.47.6.1147. [DOI] [PubMed] [Google Scholar]
  4. Burggraf G. W., Parker J. O. Prognosis in coronary artery disease. Angiographic, hemodynamic, and clinical factors. Circulation. 1975 Jan;51(1):146–156. doi: 10.1161/01.cir.51.1.146. [DOI] [PubMed] [Google Scholar]
  5. DeMots H., Bonchek L. I., Rösch J., Anderson R. P., Starr A., Rahimtoola S. H. Left main coronary artery disease. Risks of angiography, importance of coexisting disease of other coronary arteries and effects of revascularization. Am J Cardiol. 1975 Aug;36(2):136–141. doi: 10.1016/0002-9149(75)90516-0. [DOI] [PubMed] [Google Scholar]
  6. Gould K. L., Lipscomb K. Effects of coronary stenoses on coronary flow reserve and resistance. Am J Cardiol. 1974 Jul;34(1):48–55. doi: 10.1016/0002-9149(74)90092-7. [DOI] [PubMed] [Google Scholar]
  7. Lavine P., Kimbiris D., Segal B. L., Linhart J. W. Left main coronary artery disease. Clinical, arteriographic and hemodynamic appraisal. Am J Cardiol. 1972 Dec;30(8):791–796. doi: 10.1016/0002-9149(72)90001-x. [DOI] [PubMed] [Google Scholar]
  8. Lim J. S., Proudfit W. L., Sones F. M., Jr Left main coronary arterial obstruction: Long-term follow-up of 141 nonsurgical cases. Am J Cardiol. 1975 Aug;36(2):131–135. doi: 10.1016/0002-9149(75)90515-9. [DOI] [PubMed] [Google Scholar]
  9. Logan S. E. On the fluid mechanics of human coronary artery stenosis. IEEE Trans Biomed Eng. 1975 Jul;22(4):327–334. doi: 10.1109/tbme.1975.324453. [DOI] [PubMed] [Google Scholar]
  10. Newman D. L., Walesby R. K., Bowden N. L. Hemodynamic effects of acute experimental aortic coarctation in the dog. Circ Res. 1975 Jan;36(1):165–172. doi: 10.1161/01.res.36.1.165. [DOI] [PubMed] [Google Scholar]
  11. Roy P., Day L., Sowton E. Effect of new beta-adrenergic blocking agent, Atenolol (Tenormin), on pain frequency, trinitrin consumption, and exercise ability. Br Med J. 1975 Jul 26;3(5977):195–197. doi: 10.1136/bmj.3.5977.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Webster J. S., Moberg C., Rincon G. Natural history of severe proximal coronary artery disease as documented by coronary cineangiography. Am J Cardiol. 1974 Feb;33(2):195–200. doi: 10.1016/0002-9149(74)90274-4. [DOI] [PubMed] [Google Scholar]
  13. Zeft H. J., Manley J. C., Huston J. H., Tector A. J., Auer J. E., Johnson W. D. Left main coronary artery stenosis; results of coronary bypass surgery. Circulation. 1974 Jan;49(1):68–76. doi: 10.1161/01.cir.49.1.68. [DOI] [PubMed] [Google Scholar]

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