Repair of Late Vein Graft Occlusions

Repair of graft stenosis or occlusion has been attempted in seven patients with reversed autogenous vein grafts. In one patient, bilateral grafts became stenotic and in one two occlusions occurred in one graft, making a total of nine repairs in eight grafts. All grafts were salvaged except one and a new graft was required in this patient. The time of reoperation varied from 7 to 89 months after the initial graft, with an average time of 32 months. Five stenoses were thought to be due to valve cusp fibrosis, two to intimal thickening and one to atheroma. One recurrent occlusion was embolic in nature. The importance of early angiographic assessment of suspected graft occlusion is emphasized.