Author + information
- Received February 13, 1992
- Revision received July 28, 1992
- Accepted July 30, 1992
- Published online February 1, 1993.
- Kwang Kon Koh, MDa,∗,
- Hweung Kon Hwang, MD∗,
- Pan Gum Kim, MD∗,
- Sang Hoon Lee, MD∗,
- Sang Kyoon Cho, MDa,
- Sam Soo Kim, MDa,
- Jae Jin Han, MD∗,
- Young Tak Lee, MD∗,
- Pyo Won Park, MD∗ and
- Dong Heon Yoon, MD∗
- ↵∗Address for correspondence: Kwang Kon Koh. MD, Division of Cardiology, Department of Internal Medicine, Inha University Hospital, 3309-327 Tae Pyeong-dong, Sungnam-shi, Kyunggi-do, Korea. 461-192.
Objectives. This study was performed to determine whether there are differences in the operative, histopathologic, angiographic and clinical findings of isolated ostial stenosis between Oriental and western patients.
Background. Angiographic, clinical and histologic findings in isolated ostial stenosis have been reported in western but not in Oriental patients.
Methods. Six patients, all women (0.88% of a total of 684 patients who underwent coronary angiography between March 1989 and July 1991), were found to have isolated left main coronary ostial stenosis. We performed surgical ostial angioplasty with the autologous pericardial or saphenous venous patch and biopsy at the aortic arteriotomy site in four of the six patients.
Results. All six patients presented with severe angina (angina class III or IV) of short duration (mean ± SD 6.2 ± 6.2 months) and had a very low incidence of risk factors, although histopathologic examination showed typical atherosclerosis in four of the six patients. They were young to middle-aged women (mean 45 ± 3 years) except for Patient 6 (62 years). Exercise duration was short and ST segment depression, accompanied by typical angina, was observed in many leads in the warm-up period or stage I. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. There was no angiographically definable collateral circulation from either ipsilateral or contralateral vessels except for grade I collateral circulation in Patient 5, Operative findings demonstrated mostly yellow atheroma in the aortic wall and left cornary ostium. Coronary angiography showed only ostial stenosis of the left coronary artery in all six patients, but operative findings documented atheromatous change in the left main coronary artery in two of the six.
Conclusions. The clinical, angiographic, histopathologic and operative findings of Oriental patients were similar to those reported in western patients, but the incidence of isolated left main coronary ostial stenosis was higher in the Oriental group. Angiographically definable isolated coronary ostial stenosis may often not be true isolated ostial stenosis.
- Received February 13, 1992.
- Revision received July 28, 1992.
- Accepted July 30, 1992.