Isolated coronary ostial stenosis compared with left main trunk disease

Isolated coronary ostial stenosis (OS) is a rare disease of unknown etiology. Five cases of OS were observed amongst 700 elective coronary bypass patients, and were compared with 111 cases of atherosclerotic left main trunk disease (LMTD) to clarify clinical characteristics. Mean age for LMTD patients was 61.2 years, while, it was 43.0 years for OS patients. 4 patients out of the 5 cases (80%) in the OS group were female, but there were only 10 females (9%) in the LMTD group. 60% of the OS group presented unstable angina without any episodes of myocardial infarction. 69.4% of the LMTD group presented stable angina, and 42% had a previous myocardial infarction. Left ventricular function was well preserved in the OS group compared to the LMTD group. Aorto-coronary bypass grafting was the only surgical method of our choice in both groups. The average number of grafts were 2.2 for the OS group, and 2.4 for LMTD group. Operative mortality was 0% for the OS group and 0.9% for the LMTD group. Clinical and angiographic profiles of ostial stenosis suggest that this group may represent a distinct entity, different from the more common atherosclerotic left main trunk stenosis. Coronary bypass grafting can provide good operative prognosis in ostial stenosis as well as in left main trunk stenosis.