Location of Coronary Arterial Occlusions and Their Relation to the Arterial Pattern

Abstract

The present study shows that the coronary artery pattern is not related to the prognosis after infarction nor can it be correlated with the incidence of occlusion or with the severity of atherosclerosis. This analysis re-emphasizes the severity of the occlusive process in patients with angina pectoris and, conversely, the relatively large percentage of patients having coronary occlusion who had either congestive heart failure or who were asymptomatic. The proper selection of patients for coronary artery surgery requires accurate angiography. The occurrence of multiple occlusions in a large number of cases points to certain difficulties in the interpretation of the coronary angiogram and also indicates the extremely limited role endarterectomy may be expected to play in the therapy of angina pectoris. Until such a time as the operative mortality and secondary failure rate, due to restenosis, can be reduced through new surgical technics, coronary endarterectomy should be considered an experimental procedure to be investigated vigorously in the laboratory but not to be applied for therapeutic purposes in man.