Outcome of Patch Angioplasty for Left Main Coronary Ostial Stenosis.
- Author:
Chang Hyun KANG
1
;
Chan Young NA
;
Hong Joo SEO
;
Jae Hyun KIM
;
Cheul LEE
;
Yoon Hee CHANG
;
Seong Wook HWANG
;
Man Jong BAEK
;
Sam Se OH
;
Woong Han KIM
;
Young Tak LEE
;
Chong Whan KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Korea. koreaheartsurgeon@hanmail.com
- Publication Type:Original Article
- Keywords:
Coronary artery bypass;
Ostial stenosis;
Angioplasty, surgical;
Aortic valve insufficiency
- MeSH:
Angioplasty*;
Aortic Valve Insufficiency;
Arteries;
Atherosclerosis;
Constriction, Pathologic*;
Coronary Angiography;
Coronary Artery Bypass;
Female;
Follow-Up Studies;
Freedom;
Hemodynamics;
Hospital Mortality;
Humans;
Male;
Mortality;
Pulmonary Artery;
Risk Factors;
Survival Rate
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2004;37(1):56-63
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. MATERIAL AND METHOD: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1+/-12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. RESULT: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2+/-6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4+/-8.5%. Aortic regurgitation less than grade I had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. CONCLUSION: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.
