[The fate of patients with stenosis of the trunk of the left coronary artery].

We have studied the fate of 49 patients with stenosis of the trunk of the left coronary artery of more than 50%. The follow-up period extends from 1,5 years to 5 years (with a mean of 33.83 +/- 13.55 months). The clinical picture was not characteristic. Unstable angina was found in 59% of cases. The exercice test (29 patients) was positive in 100%, with a mean depression of 3.3 mm. Stenosis of the trunk, which is rarely an isolated condition (8% of cases), is usually associated with disorders of the other main coronary vessels. Twenty six patients underwent surgery. Thirteen patients who were operable were treated medically. The performance of the left ventricle and the degree of involvement of the coronary arteries were comparable in these two groups. Seven inoperable patients were treated medically. Actuarial survival curves show a significant difference (p less than 0.01) in survival after two years between the operated cases (88%), the operable cases treated medically (60%), and the inoperable cases (57%). The decreased mortality of the operated cases corresponds also with a greater functional capacity in the survivors compared with that of the cases treated medically.