The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 389-391, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Total occlusion of left coronary artery. Incidence and management
IK Crosby, HA Wellons Jr and L Burwell
From July 1, 1972, to Jan. 1, 1978, 527 patients underwent coronary
revascularization. In four (0.76%) of these patients arteriography
demonstrated total occlusion of the left main coronary artery. The
incidence of acquired occlusion of the left coronary artery encountered in
the cardiac catheterization laboratory during the same period was 0.17% in
patients undergoing coronary arteriography. Literature review reveals 13
patients with total occlusion of the left coronary artery, and only seven
of these were treated operatively, some with suboptimal results. With an
average of three grafts per patient, all four of our patients are in Class
I of the New York Association an average of 23 months postoperatively.
These patients were dramatically symptomatic preoperatively, and their
clinical management in terms of pharmacologic or mechanical intraoperative
support was no different from that of patients with critical stenosis of
the left main coronary artery. This report documents the incidence of left
coronary artery occlusion encountered in clinical practice. This incidence
should not be as rare as the literature review suggests.
