Surgical versus medical treatment in disease of the left main coronary artery.

Data from 179 patients with a significant lesion of the left main coronary artery were reviewed to compare survival with and without bypass graft surgery. 149 patients were treated with bypass grafting. Of 38 patients treated medically, 24 were suitable for surgery but either had been evaluated before the widespread use of bypass grafting procedures or preferred medical treatment. Major prognostic factors in this group were comparable to the surgical patients. The survival-rate was consistently higher for the surgically treated group and differed significantly (P less than 0-02) for the total duration of follow-up. At twelve months, 89% of the surgical group were alive, but only 73% of the comparable medical group; at twenty-four months, survival-rates were 86% and 65% respectively. These findings, corroborated by other data, suggest that surgery prolongs life for these patients.