Does Aortocoronary Saphenous Vein Bypass Surgery Change the Native Coronary Arteries?

ABSTRACT. Progression of disease in the native coronary circulation was studied in 60 patients before and after aortocoronary saphenous vein bypass surgery. The mean interval between the first angiographic study and operation was 2.0 months and the mean interval from operation to second catheterization was 15.3 months. The results from a second arteriographic study after an interval of 12.3 months on 25 comparable patients, with no surgery in between, served as a control material for frequency and severity of the “natural” progression of the disease. Only vessels which were not occluded at the first examination were included in the re‐study. In the 60 operated patients, 106 arteries were grafted and 74 ungrafted. Total graft patency at the time of re‐study was 66%. Progression was found in segments proximal to the anastomosis in 42% of arteries with patent graft, and in 47% of arteries with occluded graft, whereas in segments distal to the site of anastomosis progression was found in 5% of the arteries with patent graft and in 55% of arteries with occluded graft. Progression of the disease was found in 11% of ungrafted arteries. In the control group, progression of the disease was found in 24%. The study thus shows that after aortocoronary bypass surgery, progression in segments proximal to the anastomosis is significantly higher than in nongrafted arteries. The progression was independent of patency or occlusion of the graf to the vessel. Progression in the segments distal to the anastomosis was not significantly different from the frequency of progression seen in nongrafted arteries if the graft was patent, but was much higher if the graft was occluded.