d'Allonnes F Revault, Corbineau H, Le Breton H, Leclercq C, Leguerrier A, Daubert C
Department of Cardiology, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
Heart. 2002 Jun;87(6):544-8. doi: 10.1136/heart.87.6.544.
To analyse the long term prognosis in patients with isolated stenoses of the left main coronary artery (LMCA) following surgical revascularisation.
106 patients (71 men and 35 women, mean age 61 years) were operated on between 1982 and 1998. Before surgery, 103 patients presented with angina pectoris and only 10 had a history of myocardial infarction. Their mean left ventricular ejection fraction was 62%. Stenoses were localised on the LMCA ostium in 19 patients, a subgroup characterised by a high proportion of women (68%). Three patients presented with chronic LMCA occlusion. Forty six patients were operated on as an emergency. The mean (SD) number of grafts per patient was 2.0 (0.5), and only one patient had no left anterior descending (LAD) coronary artery bypass. Bypass of the LAD using the internal thoracic artery was performed in 88 cases.
Early postoperative mortality was 4.7% and the five year survival was 86.8%. Late mortality occurred in nine cases, and in three of these it was linked to a coronary condition. Of the 92 long term survivors, 81.5% were totally symptom-free and 77% of those of working age were able to resume work. The postoperative outcome of patients with isolated ostial LMCA stenosis did not differ significantly from that of the other patients.
The postoperative prognosis of isolated LMCA stenosis appears good in terms of mortality and symptoms.
分析左主干冠状动脉（LMCA）孤立性狭窄患者手术血运重建后的长期预后。
1982年至1998年间对106例患者（71例男性和35例女性，平均年龄61岁）进行了手术。手术前，103例患者有胸痛症状，仅有10例有心肌梗死病史。他们的平均左心室射血分数为62%。19例患者的狭窄位于LMCA开口处，该亚组的特点是女性比例高（68%）。3例患者表现为慢性LMCA闭塞。46例患者作为急诊进行手术。每位患者移植血管的平均（标准差）数量为2.0（0.5），只有1例患者没有左前降支（LAD）冠状动脉搭桥。88例患者使用胸廓内动脉进行了LAD搭桥。
术后早期死亡率为4.7%，五年生存率为86.8%。9例发生晚期死亡，其中3例与冠状动脉疾病有关。在92例长期存活者中，81.5%完全无症状，77%达到工作年龄的患者能够恢复工作。孤立性LMCA开口处狭窄患者的术后结果与其他患者相比无显著差异。
就死亡率和症状而言，孤立性LMCA狭窄的术后预后似乎良好。
