Coronary Artery Bypass in Patients with Left Main Disease: Long-Term Results

Left main coronary artery disease (LMCAD) is a particularly severe form of coronary artery disease (CAD); its frequency ranges from 5% of 7% in patients with CAD [4, 6, 7] and virtually all published reports show a grim natural history: the survival rate of medically treated patients with LMCAD ranges from 65% to 57% at 2 years [9, 16], from 49% to 46% at 5 years [3, 13], and from 13% to 31% after 10 years [19]. Coronary artery bypass grafting (CABG) is generally accepted as the treatment of choice in these patients and randomized studies of large series have shown a significantly better prognosis for the operated patients, with 88% or 86% survival at 4 years [5, 7]. The data obtained from our experience with 155 consecutive cases of LMCAD treated by CABG form the basis of this report.