Aortocoronary bypass for critical stenosis of the left main coronary artery.

Over a 2-year period 33 patients with symptomatic stenosis (greater than 75%) of the left main coronary artery underwent aortocoronary bypass. Intra-aortic balloon counterpulsation was used preoperatively in only two patients as a therapeutic measure for medically unstable angina. There were no operative deaths. Follow-up study 3 to 27 months (mean 13.3 months) after operation revealed one death. Twenty-two patients were free of pain. The authors conclude that aortocoronary bypass surgery for severe stenosis of the left main coronary artery can be safely accomplished, without prophylactic use of intra-aortic balloon counterpulsation in the majority of cases, with an acceptable operative mortality and morbidity.