Prospective Angiographic Assessment of Factors Affecting Early Patency of Saphenous Vein‐Coronary Artery Bypass Grafts

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Abstract
Between Nov. 1977-Sept. 1978, early post-operative angiography was performed in 50 of 53 consecutive patients undergoing coronary artery bypass surgery. An average of 2.4 grafts per patient were applied. The overall patency rate was 82% and was not affected by the degree of proximal native vessel stenosis. Grafts to circumflex marginal vessels had a significantly lower (P < 0.05) patency rate (72%) than grafts to the left anterior descending (84%) and its diagonal branches (85%) or to the right coronary artery (90%). Ten single grafts were applied and all were patent. Of the 50 patients, 49 had at least 1 patent graft. Of the grafts, 53% were considered of excellent quality and 25% patent but of fair quality only. There was a 100% patency rate for vessels of 2 mm diameter or more, which is significantly better (P < 0.01) than for vessels of 1-2 mm diameter (78%) or for vessels of < 1 mm diameter (50%). There was a suggestion of a lower patency rate (74%) for vessels with evidence of distal disease, compared with vessels without such disease (85%). An assessment of the overall quality of the recipient vessel was made, taking diameter and disease into account. This showed improved results for better quality vessels in terms of graft patency (P < 0.01) and graft quality (P < 0.05).