Abstract
Background: The association of right coronary artery (RCA) stenosis in patients undergoing myocardial revascularization for left main coronary artery (LMCA) stenosis affects the prognosis. This study aimed to compare immediate results of patients with isolated LMCA stenosis and those with combined RCA stenosis. Patients and methods: We retrospectively evaluated 107 consecutive patients with LMCA disease who underwent coronary artery bypass grafts. The patients were divided into two groups: isolated LMCA stenosis (n = 36) and LMCA stenosis + RCA stenosis (n = 71). Different variables (preoperative, intra operative and post operative) were compared. Results: Patients with LMCA stenosis + RCA stenosis experienced higher prevalence of diabetes mellitus (p = 0.024) and smoker (p = 0.032). Also left ventricular EF was reduced (p = 0.004). Myocardial revascularization was more complete in patients with LMCA stenosis + RCA stenosis (p = 0.033), but in-hospital mortality rate was higher (12.6% vs 5.5%) in isolated LLMCA stenosis, but it did not reach statistical significance (p = 0.32). Except low output syndrome (LOS) that was frequent in presence of RCA stenosis (p = 0.026), no significant difference was found between groups for other complications. Conclusion: The presence of RCA stenosis in patients undergoing CABG for LMCA disease increases 30 day mortality but without significant impact on overall morbidities.
Highlights
Unprotected left main coronary artery (LMCA) stenosis occurs in 5% of patients undergoing coronary angiography [1]
The present study showed that associated right coronary artery (RCA) stenosis disease with LMCA stenosis increases incidence of adverse events and in-hospital mortality without statistical significance
Numerous studies have shown that stenosis of LMCA is of critical prognostic importance [17], and it is known to be associated with high rate of complications during and after coronary angiography [18] [19]
Summary
Unprotected left main coronary artery (LMCA) stenosis occurs in 5% of patients undergoing coronary angiography [1]. It has a worse prognosis than other forms of coronary artery disease [2]. The association of right coronary artery (RCA) stenosis in patients undergoing myocardial revascularization for left main coronary artery (LMCA) stenosis affects the prognosis. Myocardial revascularization was more complete in patients with LMCA stenosis + RCA stenosis (p = 0.033), but in-hospital mortality rate was higher (12.6% vs 5.5%) in isolated LLMCA stenosis, but it did not reach statistical significance (p = 0.32). Conclusion: The presence of RCA stenosis in patients undergoing CABG for LMCA disease increases 30 day mortality but without significant impact on overall morbidities
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