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The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 248-258, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
BW Lytle, FD Loop, DM Cosgrove, NB Ratliff, K Easley and PC Taylor
Serial arteriograms were obtained in 501 patients after coronary bypass
grafting. Study I within 5 years of operation (mean interval 15 months) and
Study II more than 5 years after (mean interval 88 months, range 60 to 147
months). One hundred patients received both internal mammary artery and
saphenous vein grafts: 37, mammary artery grafts only, and 364, vein grafts
only. In Study I, 645 (82%) of 786 vein grafts were patent, 42 (5%)
stenotic or irregular, and 99 (13%) occluded. Of 140 mammary artery grafts,
136 (97%) were patent, two (2%) stenotic, and two (2%) occluded. Of the 645
vein grafts patent in Study I, 357 (55%) remained patent in Study II, 119
(18%) were stenotic or irregular, and 169 (26%) were occluded. Of 136
mammary artery grafts patent in Study I, 130 (96%) were unchanged, one was
stenotic, and five (4%) were occluded in Study II. Early vein graft patency
was influenced by the coronary artery grafted and by angina. Progression of
vein grafts patent at Study I to stenosis or occlusion at Study II was
associated with increasing postoperative interval (p less than 0.00001),
interval myocardial infarction (p less than 0.001), angina (p less than
0.001), diabetes (p less than 0.004), hypercholesterolemia (p less than
0.006), and hypertriglyceridemia (p less than 0.02); it was not influenced
by the coronary artery grafted. Within 5 years of operation, mammary artery
graft patency exceeded vein graft patency. Between 5 and 12 years after
operation, the attrition rate of vein grafts greatly exceeded that of
mammary artery grafts (p less than 0.0001).
ARTICLES
Long-term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts
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