THE SIGNIFICANCE OF TOTAL PROXIMAL ANTERIOR DESCENDING VESSEL OCCLUSION.

A series of 100 consecutive patients demonstrating total occlusion of the proximal left anterior descending coronary artery by cineangiography were analyzed. Forty-five showed occlusion proximal to the first septal branch. Collaterals to the anterior descending vessel were present in 83 cases. Left ventriculography revealed normal contractility in 16 cases and localized aneurysms in twenty-two. In 18 instances the left anterior descending lesion was the only occlusion demonstrated. Double and triple vessel involvement was present in 35 and 45 respectively. Normal EKGs were seen in 22 cases and signs of transmural anterior infarction in forty-two. Neither the development of ventricular aneurysm nor the presence of anterior wall infarction by EKG appeared to be influenced by the site of occlusion with respect to the septal branch. All the patients with normal left ventricular contractility had demonstrable collaterals.