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  • Title: Complete occlusion of the left main coronary artery: report of three surgical cases and review of the literature.
    Author: Kawasuji M, Hetzer R, Oelert H, Borst HG.
    Journal: Thorac Cardiovasc Surg; 1981 Jun; 29(3):183-6. PubMed ID: 6167020.
    Abstract:
    Out of 75 consecutive patients with left main coronary artery (LMCA) obstruction who underwent coronary revascularization between January and October 1980, 3 patients had total occlusion of the LMCA. All 3 patients were suffering from severe angina pectoris preoperatively. On cardiac catheterization they had shown extensive collaterals from the right coronary artery and relatively well-preserved left ventricular function. In addition to intercoronary anastomoses a relatively high extracoronary collateral blood flow was measured at operation. Postoperatively the 3 patients remained free of angina (class I NYHA) at 5, 20 and 50 months after uneventful surgery. It is concluded that patients with adequate intercoronary and extracoronary collaterals may well survive complete occlusion of the LMCA. Surgery appears to carry a low risk no greater than that involved in conservative treatment of LMCA stenosis and the postoperative clinical status of the patients continues to be satisfactory.
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