Campeau L, Corbara F, Crochet D, Petitclerc R
Circulation. 1978 Jun;57(6):1111-5. doi: 10.1161/01.cir.57.6.1111.
A retrospective study was carried out in 114 unoperated and 197 operated patients having left main coronary artery (LMCA) stenosis greater than or equal to 50%. Including the operative mortality of 9.1%, survival at seven years was significantly greater following pure aortocoronary bypass graft surgery, 77.5% as compared to 48.5% for the unoperated patients (P less than 0.01). The surgical mortality was significantly less during the last five years (1972-1976), 6.2% as compared to 17% during 1969-1971 (P less than 0.025). The three year survival in patients operated since 1972 was 90.2% as compared to 60.4% for unoperated patients. Survival remained significantly higher in the operated patients when studied as subsets on the basis of the severity of the LMCA stenosis (less than 70% as opposed to greater than or equal to 70%), and on the extent of associated obstructive disease of major coronary arteries (0-1 versus 2-3 arteries). It was significantly higher, however, only in operated patients with associated stenosis greater than or equal to 70% of the right coronary artery. Survival was higher following surgery only when the ejection fraction was at least 0.45, or the left ventricular end-diastolic pressure below 20 mm Hg.
对114例未经手术治疗和197例接受手术治疗的左主干冠状动脉（LMCA）狭窄大于或等于50%的患者进行了一项回顾性研究。包括9.1%的手术死亡率，单纯主动脉冠状动脉搭桥手术后七年生存率显著更高，为77.5%，而未经手术治疗的患者为48.5%（P<0.01）。在过去五年（1972 - 1976年）手术死亡率显著更低，为6.2%，而1969 - 1971年为17%（P<0.025）。自1972年以来接受手术治疗的患者三年生存率为90.2%，而未经手术治疗的患者为60.4%。根据LMCA狭窄的严重程度（小于70%与大于或等于70%）以及主要冠状动脉相关阻塞性疾病的范围（0 - 1支动脉与2 - 3支动脉）作为亚组进行研究时，手术患者的生存率仍然显著更高。然而，仅在右冠状动脉相关狭窄大于或等于70%的手术患者中生存率显著更高。仅当射血分数至少为0.45或左心室舒张末期压力低于20 mmHg时，手术后生存率更高。
