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kitab tajul urus pdf downloadSurgical treatment of left main coronary artery aneurysm. Aneurysm of the left main coronary artery (LMCA) is an uncommon coronary pathology that has a high mortality if untreated. The aim of this study was to review the authors' experience in the surgical treatment of this pathology. From January 2007 to September 2012, in our institution, 14 patients (11 men and 3 women) with LMCA aneurysm were treated by left internal mammary artery grafting (LIMA-LIMA) with associated surgical treatment. Patients with LMCA aneurysm have a high mortality if untreated. Limitation of the amount of myocardium inoperable and incomplete revascularization after surgery are the main causes of death. In this study we present our experience in the surgical treatment of LMCA aneurysm. Between January 2007 and September 2012, in our institution, 14 patients (11 men and 3 women) with LMCA aneurysm were treated by LIMA-LIMA with associated surgical treatment. The median age of the patients was 58 years. All patients presented symptoms of coronary artery disease. The aneurysm was associated with left anterior descending (LAD) and circumflex (CX) coronary arteries in 4 and 6 patients, respectively. Twelve patients had history of myocardial infarction (MI), and 4 patients had angina. Three patients had extensive anterior wall myocardial infarction, while 2 patients had aneurysm only in the CX coronary artery. Left ventricular ejection fraction was 50-60% (mean 54 ± 5.4%). The LIMA-LIMA with anastomosis on the LAD and CX coronary arteries was performed in all patients. All operations were performed using extracorporeal circulation. The median length of operation was 220 (180-325) minutes and the median cardiopulmonary bypass time was 145 (100-215) minutes. Postoperative course was uneventful in all patients. All grafts were patent at the end of the first postoperative month. There were no in-hospital deaths. At a mean follow-up of 14 ± 6.7 months (1-33 months), no major adverse cardiac events were seen. Our results indicate that surgical treatment of LMCA aneurysm is a safe and feasible alternative, resulting in good short-term and long-term results.TUCKER CARLS
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