CORONARY ECTASIA - INCIDENCE AND RESULTS OF CORONARY-BYPASS SURGERY

Coronary angiograms were performed in 1660 patients between the ages of 27 and 84 yr. Coronary ectasia was noted in 42 (2.5%) patients. These 42 patients were compared with an equal number of patients with coronary artery disease, matched for age and sex. There were no significant differences in numbers of vessels involved with significant disease, coronary score, main left or left anterior descending artery disease, coronary calcification, hypertension, or abnormal glucose tolerance test in patients with or without ectasia. A family history of coronary artery disease, diabetes mellitus and hypertension did not separate the groups, neither did serum cholesterol level. The serum level of triglyceride was higher in the coronary ectasia group (P < 0.025). The location of infarction by ECG or abnormal left ventricular contractility was similar in both groups. Of 64 ectatic vessels, 34 (53%) occurred in the right coronary, 16 (25%) in the left anterior descending and 14 (22%) in the left circumflex artery. Patients (30) with ectasia and 26 in the control group underwent bypass surgery. Nineteen of the ectasia group and 17 of the control group had post-bypass graft angiograms. In the ectasia group, 2 out of 47 and, in the control group, 5 out of 41 grafts were closed. The postoperative course was similar in both groups. An 18 mo. (mean) follow-up of the 42 patient with coronary ectasia revealed no late deaths, wereas 1 death occurred in a control patient who did not have surgery. In conclusion, coronary ectasia is more common in the right coronary artery. The presence of coronary ectasia does not indicate more severe or widespread coronary disease than in controls. Short term follow-up of patients with ectasia, with or without bypass surgery, does not differ from control patients.