Teniente-Valente R, Lemarroy-Mendoza L, Mendoza-Gómez R, Solórzano-Zepeda FJ, Vallecillo-Gómez A, Cruz-Cervantes R, Gasca-Reyes E, Martínez OMC

Language: Spanish
References: 19
Page: 86-93
PDF size: 90.02 Kb.

ABSTRACT

Objectives: To know the clinical characteristics before surgery, morbility and mortality during the cardiac catheterization and surgery results of the left main coronary artery (LMCI). Methods: Of the cardiac catheterization from January 1997 to July 2002 we selected the cases with obstructive disease of the LMCI with luminal narrowing of at least 50%. Results: In 1,946 patients who underwent coronary angiography there were 47 cases with LMCI (2.4%). Five files were not found and were excluded, leaving 42 cases, 10 women and 32 men, average age 62.6 years (44 to 78). 71.4% had elevation of serum cholesterol, 69% were smokers and 62.4% hypertension. 21 patients (50%) had stable angina, 15 patients (37.5%) had unstable angina and 6 patients (14.3%) had acute myocardial infarction. 17 patients (40.5%) had ECG evidence of remote myocardial infarction. Exercise testing for 25 patients was positive in 88% and in the 55% ST-T depression was 2 or more mm. The average of the left ventricular end-diastolic pressure was 11.1 mm Hg (0 to 40). The average ejection fraction was 60.4% (18 to 87). Left anterior descending was sick in 80.9%, circumflex in 71.4% and right coronary in 66.6%. In 19 patients left ventriculogram was abnormal. There was a death during catheterization procedure. The time between catheterization and surgery was 14.6 days (1 to 60). 32 patients were operated on and 7 of them died (21.8%). Of the 25 surgical survivor two of them died in the long run by pulmonary thromboembolism and acute myocardial infarction and 23 are still alive. Conclusions: We found prevalence of 2.4%, there was one death during cardiac catheterization; mortality rate during operating time was very high.

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