title: Treatment of severe coronary artery disease with quadruple and quintuple saphenous vein grafts. Review of 100 consecutive patients.
abstract: In order to establish the anatomic criteria, the functional results, and the safety of complete myocardial revascularization for severe coronary artery disease, 100 consecutive patients who received four or five saphenous-vein grafts were analyzed. Ages ranged from 37 to 75 years (mean, 56 years). Men predominated by a ratio of 12:1. As an indication of the severity of multiple-vessel disease, 28 percent were in functional class 4, and left ventricular function was classified as good in 47 percent, as fair in 44 percent, and as poor in 8 percent. Coronary arterial scores ranged from 9 to 15 (average, 12.2). Fourteen patients had significant left main coronary arterial obstruction. All 100 patients had grafts to the left anterior descending coronary artery; 96 to the right coronary artery; 94 to the obtuse marginal branch of the circumflex; 78 to a diagonal branch of the left anterior descending; and 27 to the distal circumflex. Operative mortality was 5 percent. Nonfatal perioperative myocardial infarction occurred in 10 percent, and only one of these had low cardiac output. Follow-up from 5 to 23 months showed 95 percent of the patients to be improved, with 70 percent free of angina. Two late deaths occurred, for an overall mortality of 7 percent.
mesh_terms: D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation; D014182:Transplantation, Autologous