Vein Graft Surgery for Coronary Artery Disease

One thousand patients were operated upon with vein graft techniques for severe coronary artery obstructions between May 1967 and July 1970, with a hospital mortality rate of 4% and a 5.6% incidence of angiographically confirmed in-hospital myocardial infarctions. Postoperative angiograms, performed in 619 of the survivors, revealed patency of one or more vein grafts in 84.2% of patients, and 82.5% of all grafts were patent in studies performed 1 to 49 months after surgery. The hospital survivors were followed for 22 to 60 months; only three patients were lost to follow-up. The survival curve for this group of patients was compared with that of another group of 469 patients who also had severe coronary artery disease and were potential surgical candidates, but were studied in an earlier period and did not have surgical treatment. The annual rate of attrition for each of the four years of follow-up in the surgical group averaged 4.8% per year (2.5% per year excluding hospital mortality), and 9.3% per year in the nonsurgical group. Remission of symptoms correlated closely with the completeness of revascularization. Myocardial revascularization with vein graft techniques can be accomplished successfully and with low risk in the majority of properly selected patients, resulting in a significant improvement in symptoms, as well as in long-term survival.