Turk Kardiyol Dern Ars. 2015; 43(8): 684-691 | DOI: 10.5543/tkda.2015.07277

Long term outcomes of surgical revascularization for isolated left main coronary artery stenosis: a single-center surveillance study

Yalçýn Velibey¹, Eyup Tusun¹, Servet Altay², Nijat Nijat Bakshaliyev¹, Mehmet Karaca¹, Özge Güzelburç¹, Nihat Ozer¹, Mehmet Eren¹, Serap Aykut Aka³, Ýbrahim Yekeler^3
1Siyami Ersek Thoracic And Cardiovascular Surgery Center, Training And Research Hospital, Department Of Cardiology, Istanbul, Turkey
²Edirne State Hospital, Department Of Cardiology, Edirne, Turkey
³Siyami Ersek Thoracic And Cardiovascular Surgery Center, Training And Research Hospital, Department Of Cardiovasculary Surgery, Istanbul, Turkey

OBJECTIVE
The objective of this study was to retrospectively analyze the clinical course and postoperative long-term survival of patients diagnosed with isolated left main coronary artery (LMCA) stenosis after surgical revascularization.

METHODS
A total of 38 patients (27 males, 11 females) who were diagnosed with isolated LMCA stenosis and underwent surgical revascularization were enrolled in the study. Isolated LMCA stenosis was classified into 2 groups: ostial stenosis and nonostial stenosis. Coronary events were defined as death of cardiac origin, the need for a new myocardial revascularization procedure, or the occurrence of myocardial infarction in the course of follow-up. The postoperative assessment period included short- and long-term follow-up. The study endpoint was defined as all-cause mortality.

RESULTS
Among the 38 patients who participated in the study, 25 suffered from ostial LMCA stenosis. The early postoperative mortality rate before hospital discharge was 2.6%. Median duration of postoperative long-term follow-up was 73.43 months (range: 0.17–187.23). Median duration of long-term follow-up free from coronary events or percutaneous coronary interventions was 73.43 months. Postoperative 2-year survival rate was 97.4%, and 5-year survival rate was 92.1%. The postoperative survival period and period free of coronary events of patients with isolated ostial LMCA stenosis did not differ significantly from those of patients with nonostial stenosis (p=0.801, p=0.970, respectively).

CONCLUSION
Postoperative short- and long-term prognosis of isolated LMCA stenosis appears good in terms of mortality and coronary event symptoms.

Keywords: Coronary angiography, isolated LMCA stenosis, surgical revascularization, long-term survival

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