LEFT MAIN STEM CORONARY ARTERY STENOSIS: TWO-YEAR FOLLOWUP IN 30 PATIENTS AFTER CORONARY ARTERY BYPASS GRAFTING (CABG)

Abstract

Objective: To analyze the survival prognosis in patients with left main stem coronary artery lesion after
surgical revascularisation (CABG) in first two years.
Patients: Between August 2000 and August 2002, 30 patients (27 men and 3 women) were operated for left
main stem coronary artery lesion. Mean age was 55.97 years. Preoperatively 28 patients presented with
angina pectoris. The majority of the patients (93.3%) belonged to the New York Heart Association class III.
Mean EF was 37%. Significant four-vessel disease was present in 7 patients (23%), triple vessel disease
occurred in 21 patients (70%) and double vessel disease in 2 patients (7%). Significant co-morbid factors
included hypertension (80%), diabetes mellitus (43%), and smoking (23.3%). All the patients were operated
as an emergency. Average grafts per patient were 3.1. All patients were considered for LIMA, selection being
based upon the severity of symptoms, left ventricular function, and suitability of the coronary vessels for
grafting. LIMA was used to perform a bypass for LAD in 24 patients.
Results: Operative mortality, defined as death within 30 days of surgery, was 6.66%. Two out of total three
deaths occurred while within the hospital postoperatively. After 2 years of follow-up only one more death was
observed (3.33%). All three deaths were linked to coronary conditions. Among the survivors 96.29% (26 out
of 27 patients) remained asymptomatic after two years. Only one patient reported shortness of breath and
was categorized under angina class I of New York Heart Association.
Conclusion: Our observations suggest that post CABG survival prognosis in patients with left main stem
coronary artery lesion appears very good after two years of follow-up.