The experience of the Heart Institute of the University of Sao Paulo with surgical management of left coronary ostial lesions was made of 11 patients. They were operated on from January 1984 to July 1994. Eight of them were female, 3 were male. They were of white race. The ages ranged from 39 to 68 years old (mean 53). Two patients were asymptomatic, 2 were with unstable angina and the others with chronic angina. All of them had ostial stenosis of 90% or more. They were operated on with cardio-pulmonary bypass, posterial oblique aortotomy prolonged through the left main coronary artery. The ostioplasty was made with saphenous vein patch in 8 cases and with gluteraldehyde preserved xenopericardial patch in 3 cases. The aortic root biopsies showed inespecif mucoid infiltrations in all studied cases. All patients were angiografically studied 2 weeks after surgery. The ostial angioplasty were opened widely in all cases. One patient died 7 hours after angiografic study, and the necropy revealed a large thrombus of 8 mm inside of the left ostioplasty. One patient died 9 months later, with a diagnosis of hepatitis. The other 9 patients have been followed up from 6 months to 10 years, and are all free of angina and doing well. The results take us to believe that the surgical technique is applicable to this kind of stenosis, with good results
Coronary ostium