Aortocoronary saphenous vein bypass graft changes 5 to 7 years after surgery.
Control angiographic studies were carried out 54 to 88 months after aortocoronary saphenous vein bypass surgery (70 +/- 10 months) in 100 unselected patients who were known to have at least one patent graft 6 to 18 months following the operation. Only 17 of the 159 grafts were found occluded during this interval of 5 years, giving an average yearly attrition rate of 2.1% after the first year. The mean yearly attrition rate was 0.7% in our second series of near consecutive patients operated on after 2 years of experience and modifications of surgical techniques, and it compares favorably with the 2.4% yearly attrition rate found in our first series of patients (P < 0.05). Of the 37 grafts having localized stenoses at 1 year, eight became occluded (21.6%), and four became worse. Grafts with localized stenoses were more prone to late occlusion, whereas no late occlusion was observed in normally appearing grafts at 1 year. Diffuse graft narrowing noted during the first year showed no further change during the subsequent 5 years, and it did not appear to lead to late occlusion. Finally, in 14 grafts, localized narrowing developed after the first year, at a yearly rate of 1.5%. Atherosclerosis appears to be the most likely etiology, being found in two of these instances at reoperation.
Campeau
L
L
Montreal Heart Institute, 5000 East, Belanger Street, Montreal, Quebec, HIT 1C8, Canada.
Lespérance
J
J
Corbara
F
F
Hermann
J
J
Grondin
C M
CM
Bourassa
M G
MG
D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery; D023903:Coronary Restenosis / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D013997:Time Factors