The Annals of Thoracic Surgery, Vol 36, 193-201, Copyright © 1983 by The Society of Thoracic Surgeons
Surgical treatment of 200 consecutive patients with left main coronary artery disease
DL Jeffery, R Vijayanagar, DA Bognolo, PF Eckstein, E Spoto Jr, P Natarajan, EH Willard 3d and RG Connar
Two hundred consecutive patients underwent myocardial revascularization for
left main coronary artery disease between January, 1975, and December,
1981. The mean age of this group was 64 +/- 8 years, and 78.5% of the
patients were men. The anginal pattern was chronic stable in 6% of the
patients and progressive or unstable in the remainder. Resting
electrocardiograms showed prior myocardial infarction in 45.5%. Left
ventricular end-diastolic pressure was elevated in 145 patients, and
ejection fraction was less than 50% in 40 patients. The mean number of
bypass grafts per patient was 3.2 +/- 1.4 (standard deviation). Seventeen
patients underwent major concomitant cardiovascular procedures. The
operative mortality was 3.5%, and the incidence of perioperative infarction
was 3%. Factors associated with reduced operative survival were increased
age; unstable angina, or acute myocardial infarction, or both; female sex;
circumflex-dominant circulation; and major concomitant procedures. Late
mortality at a mean follow-up of 33.5 months was 6%, and 91% of the
surviving patients assessed their quality of life as "excellent" or "good."
