Surgical angioplasty of isolated stenosis of the left main coronary artery(LMCA) restores a more physiologic flow to the myocardium, allows percutaneous transluminal coronary angioplasty (PTCA) of distal coronary stenoses at a later stage, and is
a
less
time consuming and convenient procedure than the conventional coronary artery bypass grafting(CABG). Between Jul. 1994 and Dec. 1995, 7 surgical angioplasty had been performed. LMCA stenoses involved ostium in 2 patients, middle third in 3, and
distal
third in 2. In 2 patients, the origin of left anterior descending coronary artery was involved in conjunction with LMCA.
The additional coronary artery stenoses were found in 2 cases.
One patient was emergently operated after coronary angiography following his cardiac arrest.
LMCA was approached anteriorly in all patients. The pulmonary artery was transected in 3 patients for a better exposure. The onlay patch consisted of autologous or bovine pericardium. There was no postoperative myocardial infarction or mortality.
Left
ventricular functions were well preserved in all patients. Postoperative coronary angiography revealed widely patent LMCA in 5 cases, and mild narrowing of distal anastomotic sites in 2 cases. Provided that well defined indications are followed
correctly, surgical angioplasty can be a safe alternative to conventional CABG.
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