Left main coronary artery obstruction: early surgical experience with forty-two patients

Direct coronary artery surgery was performed on 42 patients with high grade obstruction of the left main coronary artery (LMCA), with a perioperative infarction rate of 7% and a hospital mortality of 9-6%. There was no significant difference in presentation of patients with LMCA lesions and no prediction of this lesion could be made by preangiographic assessment. Significant obstructive lesions in other coronary vessels were noted in most patients, triple vessel disease occurring in 27 patients (64-3%), double vessel in 14 patients (33-3%) and the LMCA lesion was an isolated lesion in only one patient (2-4%). Right coronary lesions occurred in 35 patients (83%), left anterior descending artery artery lesions in 38 patients (90%) and left circumflex system lesions in 34 patients (81%). The surgical procedures are discussed.