ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Emergency management for acute left main coronary artery total occlusion
Erol Kurç, Onur Sokullu, Numan Ali Aydemir, Batuhan Özay, Murat Sargın, Serap Aykut Aka
Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul
DOI : 10.5606/tgkdc.dergisi.2011.037
Background: In this study, we described the survival rates of patients who underwent myocardial revascularization for acute left main coronary artery occlusion.

Methods: Thirty-two consecutive patients who underwent surgical revascularization for acute left main coronary artery occlusion (26 males, 8 females; mean age 62.9±10.9 years; range 34 to 82 years) were included in this study. The preoperative clinical and demographic variables and postoperative follow-ups were collected retrospectively to detect predictors of outcome and risk-adjusted survival rates of the patients.

Results: Early mortality was 37.5% with 12 patients. Early mortality rate was found significantly higher in patients above 65 years of age [OR 4.667 (1.0-21.65)] and patients with retrograde collateralization from the right coronary artery [OR 4.667 (1.01-21.65)]. Female gender [OR 1.889 (0.31-11.34)], diabetes mellitus [OR 2.692 (0.45-15.87)], hypertension [OR 1.615 (0.32-7.98)] and intraaortic balloon pump usage [OR 4.500 (0.67-29.80)] were not found as significant risk factors for early mortality (p>0.05).

Conclusion: Although the early mortality rate is high, surgical revascularization is still the standard treatment approach in patients with acute left main coronary artery occlusion. In patients with hemodynamic instability and without good collateral flow from right coronary artery, percutaneous intervention may be performed as a bridge to surgery.

Keywords : Acute left main coronary artery occlusion; coronary artery bypass grafting; early mortality; emergency management
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