Surgical angioplasty of the left main coronary artery
Introduction. The conventional treatment for isolated stenosis of the left main coronary artery is bypass surgery (myocardial revascularization). However, the process of atherosclerosis is not arrested by myocardial revascularization and it will lead to the occlusion of the left main coronary artery...
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| Format: | Article |
| Language: | English |
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Serbian Medical Society
2010-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2010/0370-81791002033V.pdf |
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| author | Vraneš Mile Velinović Miloš Kočica Mladen Mikić Aleksandar Velimirović Dušan Đukić Petar |
| author_facet | Vraneš Mile Velinović Miloš Kočica Mladen Mikić Aleksandar Velimirović Dušan Đukić Petar |
| author_sort | Vraneš Mile |
| collection | DOAJ |
| description | Introduction. The conventional treatment for isolated stenosis of the left main coronary artery is bypass surgery (myocardial revascularization). However, the process of atherosclerosis is not arrested by myocardial revascularization and it will lead to the occlusion of the left main coronary artery. Revascularization will establish retrograde perfusion for 50-70% of the myocardium of the left ventricle. Direct surgical angioplasty of the left main coronary artery enables normal physiological perfusion of the whole myocardium and better myocardial function. Objective. The aim of our study is to point out a new surgical approach of treating left main coronary artery stenosis. Methods. Between October 2002 and October 2003, direct surgical angioplasty of the main left coronary artery was performed on three patients with isolated stenosis of the left main coronary artery using the anterior approach and the pericardium as a patch. The procedure was performed under total endotracheal anaesthesia and standard cardiopulmonary circulation, moderate hypothermia, anterograde St. Tomas cardioplegia and local cooling. Patients were followed clinically, echocardiographically and by load-tests. Results. All three patients were without complications. In postoperative follow-up (54-68 months) neither angina pectoris nor electrocardiographically registered ischaemic changes were found. Load-tests performed every six months on all three patients were negative. Conclusion. Surgical angioplasty of isolated stenosis of the left main coronary artery is a preferred method for treating this type of coronary disease. Contraindications for this type of treatment are stenosis of the left main coronary artery with bifurcation and advanced calcification of the left main coronary artery. |
| first_indexed | 2024-12-19T15:45:53Z |
| format | Article |
| id | doaj.art-f63242f429c84332bc131a4fbf5107b4 |
| institution | Directory Open Access Journal |
| issn | 0370-8179 |
| language | English |
| last_indexed | 2024-12-19T15:45:53Z |
| publishDate | 2010-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-f63242f429c84332bc131a4fbf5107b42022-12-21T20:15:21ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792010-01-011381-2333610.2298/SARH1002033VSurgical angioplasty of the left main coronary arteryVraneš MileVelinović MilošKočica MladenMikić AleksandarVelimirović DušanĐukić PetarIntroduction. The conventional treatment for isolated stenosis of the left main coronary artery is bypass surgery (myocardial revascularization). However, the process of atherosclerosis is not arrested by myocardial revascularization and it will lead to the occlusion of the left main coronary artery. Revascularization will establish retrograde perfusion for 50-70% of the myocardium of the left ventricle. Direct surgical angioplasty of the left main coronary artery enables normal physiological perfusion of the whole myocardium and better myocardial function. Objective. The aim of our study is to point out a new surgical approach of treating left main coronary artery stenosis. Methods. Between October 2002 and October 2003, direct surgical angioplasty of the main left coronary artery was performed on three patients with isolated stenosis of the left main coronary artery using the anterior approach and the pericardium as a patch. The procedure was performed under total endotracheal anaesthesia and standard cardiopulmonary circulation, moderate hypothermia, anterograde St. Tomas cardioplegia and local cooling. Patients were followed clinically, echocardiographically and by load-tests. Results. All three patients were without complications. In postoperative follow-up (54-68 months) neither angina pectoris nor electrocardiographically registered ischaemic changes were found. Load-tests performed every six months on all three patients were negative. Conclusion. Surgical angioplasty of isolated stenosis of the left main coronary artery is a preferred method for treating this type of coronary disease. Contraindications for this type of treatment are stenosis of the left main coronary artery with bifurcation and advanced calcification of the left main coronary artery.http://www.doiserbia.nb.rs/img/doi/0370-8179/2010/0370-81791002033V.pdfcoronary diseasestenosis of the main left coronary arterysurgical angioplasty |
| spellingShingle | Vraneš Mile Velinović Miloš Kočica Mladen Mikić Aleksandar Velimirović Dušan Đukić Petar Surgical angioplasty of the left main coronary artery Srpski Arhiv za Celokupno Lekarstvo coronary disease stenosis of the main left coronary artery surgical angioplasty |
| title | Surgical angioplasty of the left main coronary artery |
| title_full | Surgical angioplasty of the left main coronary artery |
| title_fullStr | Surgical angioplasty of the left main coronary artery |
| title_full_unstemmed | Surgical angioplasty of the left main coronary artery |
| title_short | Surgical angioplasty of the left main coronary artery |
| title_sort | surgical angioplasty of the left main coronary artery |
| topic | coronary disease stenosis of the main left coronary artery surgical angioplasty |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2010/0370-81791002033V.pdf |
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