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The Journal of Thoracic and Cardiovascular Surgery, Vol 101, 1076-1081, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Clinical outcome of single versus sequential grafts in coronary bypass operations at ten years' follow-up

K Meeter, R Veldkamp, JG Tijssen, LL van Herwerden and E Bos
Department of Cardiology and Thoracic Surgery, Thorax-center, Erasmus University, Rotterdam, The Netherlands.

To evaluate the long-term outcome of the sequential aorta-coronary bypass grafting technique, we compared the results in 234 patients with single venous grafts (group I) with those of 234 patients with predominantly sequential grafts (group II). All were symptomatic for angina pectoris before operation and had either three-vessel or left main stem coronary artery disease. Operations were performed from March 1975 to June 1980. The mean follow-up period was 10.5 years (minimum 8.5; maximum 13.6). The perioperative mortality rate in group I was 3% and in group II, 1% (not significant). The survival probability at 5 years after operation for group I was 90% +/- 2% and for group II, 88% +/- 2%; at 10 years, 71% +/- 3% and 72% +/- 3%, respectively. Multivariate analysis elicited no risk difference related to graft type: group II versus group I hazard ratio, 0.82; 95% confidence interval 0.58 to 1.16 (not significant). Regarding depressed left ventricular function versus normal function, an increased risk was observed: 1.9 (95% confidence interval 1.35 to 2.75), as was the case for advanced age: 60 years or more versus less than 60 years, 1.6 (1.1 to 3.5). Thus the sequential venous grafting technique seems to have the same 10-year results as single venous grafts.

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