Endarterectomy of the left main coronary artery stenosis by a ‘transpulmonary artery approach’

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Abstract
For better visualization of the left main coronary artery, a newtechnique involving transection of the main pulmonary artery is described.With this new method it was possible to perform endarterectomy of the leftmain coronary artery in 35 patients from February 1981 to July 1987. Theendarterectomy incision was closed with a pericardial or venous patch. Wehad no mortality, and 91% are free from angina at a mean follow-up of 31months. Angiographic evaluation was performed in 19 patients revealing goodpatency of the left main artery. This procedure is safe, and we recommendit in isolated left main coronary artery stenosis without distalinvolvement and with good left ventricular function.