OCCLUSIVE CHANGES AT CORONARY ARTERY-BYPASS GRAFT ANASTOMOSIS - MORPHOLOGIC STUDY OF 95 GRAFTS

  • 1 January 1977
    • journal article
    • research article
    • Vol. 73  (5) , 668-679
Abstract
Bypass graft anastomoses (95) in 52 patients dying up to 4 yr after direct coronary revascularization were studied at autopsy by angiograms and serial histologic sectioning of the graft-artery anastomosis. When new coronary occlusions and narrowings occurred, they were adjacent to either the proximal or distal ends of the anastomosis and were due to compression or loss of circumference of the arterial lumen (40%), thrombus formation (40%), mural dissection of the coronary wall (8%) or the combination of compression and thrombosis (12%). Small coronary artery diameter, local atheromas and extension of the arteriotomy into a branch vessel were significant factors predisposing to occlusive changes. The findings emphasize the importance of careful artery selection for bypass, the need to avoid local vascular disease and branch-points and the technical difficulties encountered in the presence of local vascular lesions or small coronary arteries.

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