Does aortocoronary bypass grafting affect the progression of coronary arterial disease in grafted and nongrafted vessels?
Aortocoronary bypass grafting is associated with significant progression of proximal coronary artery stenoses to occlusion, which must be considered in postoperative assessment.
Coronary angiography was carried out pre- and postoperatively, and angiographic patency of vein grafts was assessed two weeks and one year after surgery in 105 patients (154 grafts). Proximal coronary artery stenoses progressed to occlusion in 12 of 13 grafts (92%), occluded after two weeks, in 6 of 15 grafts (40%) occluded after one year, and in 34 of 59 grafts (58%) patent after one year. Nine of 103 patent grafts (8%) showed progression of lesions in vessels distal to the graft. Twelve patients (13%) showed progression of atherosclerosis in other (nongrafted) vessels. These factors significantly influence the late clinical and hemodynamic results of surgery and must be considered in the postoperative assessment of patients.
Bourassa et al. (1973) studied this question.