Left Main Coronary Artery Surgery With And Without Extracorporeal Circulation

Introduction. The presence of severe left main coronary (LMCA) stenosis (> 50%) has been considered a contraindication for off-pump surgical revascularization at our department. We have already changed this approach after January 2001.Methods. From January 2001 to November 2002, 125 consecutive patients with severe LMCA stenosis were operated on. Fifty-nine patients were operated on-pump and 66 off-pump. Pre-, intra- and postoperative variables were evaluated. The SPSS software was used for the study analyses.Results. Both groups had similar preoperative data: 88.1 vs. 83.3% males, age 64.65 vs. 66.65% years, functional status (CCS) III-IV 63.3 vs. 70%, urgent treatment 44.8 vs. 49.2%, risk factors (smoking, hypertension, diabetes mellitus, hypercholesterolemia, respiratory failure and renal failure) and ejection fraction (64.93 vs. 59.89%). Hospital mortality 3.5 vs. 6.1%, number of grafts/patient 2.59 vs. 2.86, blood loss 773 vs. 798 ml, blood transfusion requirement 2.39 vs. 2.11 units, intensive care unit stay 2.88 vs. 3.57 days and hospital stay 11.14 vs. 9.89 days, did not show any statistical significance.Conclusions. The results have been very similar. In our experience severe LMCA lesion does not condition the surgical approach. The decision is left to the discretion of the surgeon.