European Journal of Cardiovascular Medicine

Introduction: Left main coronary artery (LMCA) disease is an important risk factor for increased mortality and morbidity at all stages of diagnosis and treatment of coronary artery disease. It is often silent, with an unpredictable presentation and has diagnostic and management challenges. Myocardial protection in CABG with cardioplegic heart arrest is effective in improving surgical outcomes. CABG is recommended over PCI for any patient with stable angina, unstable angina, or in asymptomatic disease and significant left main or left main equivalent coronary stenosis. The left main coronary artery (LMCA) is still one of the most challenging areas of disease for both cardiovascular surgeons and interventional cardiologists. Aim of the study: To study the clinical presentation, clinical profile, risk factors and surgical outcomes associated with Left main coronary artery disease. Materials and Methods: This was a retrospective observational study. The study subjects were all the patients with cardioplegic arrested heart who underwent Coronary Artery Bypass Graft (CABG) over a three-year period. All such patients were assessed based on age, gender, presentation, comorbidities, ejection fractions, various vascular factors, post operative complications, mortality and morbidity. The information was obtained from case records, discharge records and death summaries. Results: A total of 100 cases were studied with 80 males and 20 females with age ranging from 21 to 70 years.  A significant association was noted between age, gender, weight, mode of presentation, comorbidities, preoperative ejection fraction, LMCA stenosis, number of vessels involved; and mortality. Conclusion: LMCA disease is an independent predictor of increased morbidity and mortality rates among patients with coronary artery disease. CABG is the traditional gold standard therapy for revascularization of LMCA disease, offering greater survival benefits. Understanding factors that predispose patients with LMCA disease to perioperative mortality is essential to formulate strategies to improve patient outcomes.