Experience In Coronary Surgery With Left Main Stem Stenosis Over Thirtytwo Months

Abstract

Introduction:
From January 1992 to August 1994, 555 patients underwent Coronary Artery Surgery (CAS). Fortyeight were found to have LMS (9%) which is onsistent with the literature for the Angiography six(12%) patients underwent emergency surgery.

Patient and Methods:
Patient Population
During this period 48 patients were diagnosed to have LMS. There were 45 (94%) males and 3 (6%) females with a median age of 52.3 (40-72) years. These patients were divided into three groups with respect to the severity of the LMS. Group I greater than 90% stenosis 14 (29.2%) patients, Group II 50-89% twentynine (60%) patients, Group III less than 50% stenosis five (10%) patients. The ejection fraction was greater than 40% in twentythree (48%) patients and it was less than 40% in thirteen (27%) patients, where as no record was available in twelve (25%) patients.

Discussion:
Most of the literature about Coronary Artery Disease (CAD) is derived from the West, little is said or written about the pattern of CAD in the Sub-continent especially Pakistan. Recent reports regarding isolated coronary ostial stenosis, shows that the incidence of ostial stenosis is more in the orient as compared to the West. In another series the operative results, mortality and perioperative infarcts were comparable to the West5.