左主干狭窄的外科治疗

目的 探讨左主干狭窄（ＬＭＳ）≥５０％患者的外科治疗效果。方法 ４２例ＬＭＳ的患者接受了冠状动脉旁路移植术（ＣＡＢＧ）。平均年龄６８．７岁。ＬＭＳ介于５０％￣７５％者１６例,大于７５％者２６例,不稳定型心绞痛２９例。按ＣＣＳＳ标准心绞痛分级,Ⅰ级２例,Ⅱ级５例、Ⅲ级１７例,Ⅳ级１８例。左室射血分数小于５０％者２４例。结果 术前平均住院时间２．３ｄ人均移植血管３．３根,无手术死亡。术后所有患者心绞痛

Surgical treatment of left main stenosis in coronary artery disease

OBJECTIVE: To study the efficacy of surgical treatment in the patients with left main stenosis of 50% or more. METHODS: Forty-two patients with left main stenosis (LMS) underwent coronary artery bypass grafting (CABG). Their mean age was 68.7 years. 16 patients had 50% to 75% LMS and 26 patients more than 75%. Twenty-nine patients had unstable angina. Seventeen patients with angina were in class III according to CCSS and 18 were in class IV. Preoperative left ventricular ejection fraction in 24 patients was beyond 50%. RESULTS: The mean preoperative hospital stay was 2.3 days. The mean number of grafts was 3.3 per patient. There was no operative death. The patients were all free from angina postoperatively. The mean follow up time was 42 (3 to approximately 78) months without death. CONCLUSIONS: Coronary artery bypass grafting is the first choice to treat left main stenosis. It is a safe and effective method. To determine properly the time of surgical intervention is helpful to reduce preoperative cardiac affairs and improve operative efficacy.