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Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Long term outcomes of surgical revascularization for isolated left main coronary artery stenosis: a single-center
Yalçın Velibey1, Eyüp Tusun2, Servet Altay3
1Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, İstanbul, Turkey. yalchinveliyev@gmail.com.
Insights
Surgical revascularization for isolated left main coronary artery (LMCA) stenosis shows good long-term survival rates. Patients experienced low mortality and coronary event rates, regardless of stenosis location.
Area of Science:
- Cardiology
- Cardiac Surgery
- Vascular Medicine
Background:
- Left main coronary artery (LMCA) stenosis is a critical condition.
- Surgical revascularization is a primary treatment for LMCA stenosis.
Purpose of the Study:
- To evaluate the clinical outcomes and long-term survival of patients with isolated LMCA stenosis after surgical revascularization.
- To compare outcomes between ostial and nonostial LMCA stenosis.
Main Methods:
- Retrospective analysis of 38 patients with isolated LMCA stenosis undergoing surgical revascularization.
- Classification of stenosis into ostial and nonostial groups.
- Assessment of short- and long-term postoperative follow-up, including coronary events and all-cause mortality.
Main Results:
- Early postoperative mortality was 2.6%.
- Median follow-up was 73.43 months, with similar long-term survival and event-free periods for ostial and nonostial stenosis.
- 5-year survival rate was 92.1%.
Conclusions:
- Surgical revascularization offers a good short- and long-term prognosis for isolated LMCA stenosis.
- Outcomes are favorable regarding mortality and coronary events.
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.
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