Anatomic Assessment of Operability by the Saphenous-Vein Bypass Operation in Coronary-Artery Disease

The distribution of obstructive coronary-artery lesions was studied in 300 hearts at autopsy to assess the potential of aortocoronary bypass. A vessel with a proximal obstructive lesion occupying more than 50 per cent of the coronary lumen and with a distal arterial segment suitable for anastomosis was regarded as operable. In general the obstructive lesions were proximal and multifocal. In the 300 hearts, 576 vessels were stenosed. Thus, 1.92 lesions per heart were encountered. The distal arterial segments were suitable for an anastomosis in 266 hearts. In 185 subjects all the obstructive lesions could have been bypassed, but in 81 only partial correction of the flow deficit would have been feasible. In 88 per cent of the hearts and 67 per cent of the lesions, the pattern of coronary-artery disease provided a favorable anatomic setting for the aortocoronary saphenous bypass operation.