The Journal of Thoracic and Cardiovascular Surgery, Vol 69, 369-372, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Revascularization of the stenotic left main coronary artery and impaired left ventricle
HC Urschel and MA Razzuk
The high mortality rate associated with revascularization for stenosis of
the left main coronary artery and impairment of the left ventricle (classes
III and IV) has been significantly reduced by a twofold approach: combating
hypotension during induction of anesthesia and preventing ischemia
resulting from anoxic arrest, often needed to facilitate the insertion of
the left coronary anastomoses. These two goals have been successfully
achieved by (1) a readiness to institute circulatory assist by means of
femoral-to-femoral cardiopulmonary bypass and (2) augmentation of coronary
flow through immediate insertion of a vein graft between the aorta and
right coronary artery, if the anatomy permits.