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Coronary ostial stenosis.

H B Barner1, K S Naunheim, K R Kanter

  • 1Department of Surgery, St. Louis University, MO.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 1, 1988
PubMed
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Atherosclerotic coronary ostial stenosis affects 2.7% of patients undergoing coronary artery bypass grafting. Symptomatic ostial lesions, particularly left ostial stenosis, necessitate surgical intervention due to hemodynamic significance.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
  • Coronary ostial stenosis, a narrowing at the origin of the coronary arteries, can be a significant finding.
  • The prevalence and characteristics of coronary ostial stenosis in patients undergoing CABG require further elucidation.

Purpose of the Study:

  • To determine the incidence and clinical features of atherosclerotic coronary ostial stenosis in patients undergoing CABG.
  • To analyze the demographic and angiographic characteristics of patients with ostial stenosis.
  • To evaluate the outcomes and implications of ostial stenosis in this patient cohort.

Main Methods:

  • Retrospective analysis of 228 patients with coronary ostial stenosis (≥50%) undergoing CABG from January 1970 to December 1986.

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  • Data collection included patient demographics, coronary angiographic findings, graft details, and clinical outcomes.
  • Statistical analysis was performed to compare characteristics and outcomes.

    • Main Results:

    • Coronary ostial stenosis was identified in 2.7% of CABG patients.
    • The left ostium was most commonly affected (77.2%).
    • Isolated ostial stenosis occurred in 17% of cases, with a female predominance (76%).
    • Patients with ostial stenosis had an average of 2.0 diseased coronary arteries.
    • One-month surgical mortality was 4.8%, decreasing to 2% in the last 4 years of the study.
    • Late mortality was predominantly noncardiac.

    Conclusions:

    • Coronary ostial stenosis is an important consideration in CABG patients.
    • Left ostial stenosis is hemodynamically equivalent to left main disease and requires operative management.
    • Symptomatic ostial lesions warrant surgical intervention.