Brandt B, Wright C B, Doty D B, Rossi N P, Ehrenhaft J L
Surgery. 1980 Apr;87(4):436-40.
Surgical experience with 100 consecutive patients with left main coronary artery stenosis (greater than 50%) was reviewed to determine the risk factors and their relationship to preoperative use of intraaortic balloon (IAB). The 30-day mortality rate was 3% and the perioperative infarction rate was 2%. There was no correlation between surgical mortality and ejection fraction (EF) (15% had EF of less than 40%), degree of stenosis (58% of the patients had greater than 70% left main stenosis), right coronary artery stenosis (81%), or the number of grafts placed. We conclude that surgery for left main coronary artery disease can be done with a low mortality rate by strict attention to the induction of anesthesia, surgical technique, and complete revascularization. In our experience, prophylactic use of the IAB does not appear to be justified and is only rarely necessary for postoperative support (one case).
回顾了连续100例左主干冠状动脉狭窄（大于50%）患者的手术经验，以确定危险因素及其与术前主动脉内球囊（IAB）使用的关系。30天死亡率为3%，围手术期梗死率为2%。手术死亡率与射血分数（EF）（15%的患者EF小于40%）、狭窄程度（58%的患者左主干狭窄大于70%）、右冠状动脉狭窄（81%）或所植入移植血管的数量之间无相关性。我们得出结论，通过严格关注麻醉诱导、手术技术和完全血运重建，左主干冠状动脉疾病的手术可以以低死亡率完成。根据我们的经验，预防性使用IAB似乎没有道理，仅在很少情况下需要用于术后支持（1例）。
