Technical possibilities for coronary artery bypass surgery and the outlook for graft patency.

In an attempt to analyse the results of saphenous bypass grafting 213 patients were re-investigated by repeat coronary, graft and left ventricular angiography. In this series, the presence of diffuse arterial disease was not considered as a contra-indication to operation. Instead, additional endarterectomy was performed. The overall patency rate was 88% and was not significantly altered by the passage of time, although the patency rate during the first 6 months was 94%. The patency rate did not appear to be influenced by the age of the patient, the severity of the lesion pre-operatively, the artery grafted nor additional endarterectomy. The run-off was judged to be good in 82% of grafts investigated before 6 months, compared to 70% of those investigated later. Progress of the disease in the native vessels appeared to be slightly accelerated in the segment proximal to the graft.