[Single vessel coronary disease. I. Differences in clinical and prognostic aspects and in surgical results in isolated lesions of the anterior descending branch and of other coronary branches].
This study includes 290 patients having a 75% or greater stenosis of a sinlge coronary vessel, divided into two groups: 205 cases with isolated lesions of the left anterior descending coronary artery (LAD) and 85 with a stenosis of the circumflex (CF) or of the right (RCA) coronary artery. The following data have been compared in the two groups: -- characters of angina; -- results of stress testing; -- extent of left ventricular contraction impairment; -- natural history of unoperated patients; -- surgical risk; -- long term survival of operated patients; -- effect of medical or surgical treatment on symptoms. Results were as follows: -- LAD patients had slightly more severe symptoms and lower exercise tolerance than CF and RCA patients; -- no significant differences were noted as regards left ventricular contraction; -- five year survival rates were only slightly different both regarding unoperated patients (80 +/- 5% survival in LAD disease group; 86 +/- 5% in CF and RCA disease) and operated cases (83 +/- 5% in LAD lesions, 86 +/- 7% in CF and RCA disease); -- surgical risk was relatively low in both groups; -- progress of symptoms after bypass surgery was very favourable. Based on these results, indications for surgery in single coronary vessel disease are discussed.