Left main coronary artery patch angioplasty: midterm experience and follow-up with spiral computed tomography

Patch angioplasty is an alternative surgical technique in cases of left main coronary artery stenosis. We report our experience with this technique, with particular mention of the use of spiral computed tomography for the follow-up of our patients.

In this retrospective study we analyzed the results obtained in all 7 patients (3 women and 4 men) who were operated on with this technique in our institution between July 1992 and August 1994. Five consenting patients also underwent graft patency assessment with spiral computed tomographic imaging.

The operation was uneventful in all patients and there were no hospital deaths. Two patients required reoperation (1 of them dying at reoperation), 1 because of restenosis of the graft and 1 because of the presence of a new stenosis in the proximal anterior descending coronary artery. The remaining 5 patients were asymptomatic after 51 +/- 2 months. Spiral computed tomographic images were artifacted and of poor quality.

Patch angioplasty of the left main coronary artery can be a valuable therapeutic method in selected cases. Conventional spiral computed tomography is not an optimal noninvasive method for the assessment of graft patency.