Haverich A, Hetzer R, Rafflenbeul W, Oelert H, Borst H G
Z Kardiol. 1982 Nov;71(11):719-26.
From 1975 through 1981 130 patients underwent coronary revascularization for significant stenosis or complete occlusion of the left main coronary artery (LMA). Hospital mortality was 4.6%, 3.3% were related to cardiac causes. The incidence of perioperative infarcts was 9.7%; in three fourths of these patients cardiovascular complications (e.g. hypertension, hypotension, arrhythmias) had occurred between start of anesthesia and start of extracorporeal circulation. Patients with a more than 90% LMA stenosis and complete occlusion of the right coronary artery appear to be at a particularly high risk both in terms of mortality and perioperative infarcts as compared to all other LMA-stenosis patients (operative mortality 15% vs. 3.5%, perioperative infarcts 15% vs. 8.8%). 3 patients with complete LMA occlusion did not suffer perioperative infarcts and survived in the long term. Follow-up investigation (mean 28.8 months) revealed late infarcts in 9 patients, 5 of which were lethal (late mortality 4.1%). Of hospital survivors, 88% were entirely asymptomatic or had very little angina pectoris (classes I and II NYHA). Cumulative survival was 84.3% at 5 years.
1975年至1981年期间，130例患者因左主冠状动脉（LMA）严重狭窄或完全闭塞接受了冠状动脉血运重建术。医院死亡率为4.6%，其中3.3%与心脏原因有关。围手术期梗死发生率为9.7%；在这些患者中，四分之三在麻醉开始至体外循环开始之间出现了心血管并发症（如高血压、低血压、心律失常）。与所有其他LMA狭窄患者相比，LMA狭窄超过90%且右冠状动脉完全闭塞的患者在死亡率和围手术期梗死方面似乎风险特别高（手术死亡率15%对3.5%，围手术期梗死15%对8.8%）。3例LMA完全闭塞的患者未发生围手术期梗死并长期存活。随访调查（平均28.8个月）显示9例患者发生晚期梗死，其中5例致命（晚期死亡率4.1%）。在医院幸存者中，88%完全无症状或仅有很少的心绞痛（纽约心脏协会I级和II级）。5年累积生存率为84.3%。
