DIFFERENT CLINICAL OUTCOME IN CORONARY-ARTERY BYPASS WITH SINGLE AND SEQUENTIAL VEIN GRAFTS - A 15-YEAR FOLLOW-UP-STUDY

Objective: In trying to answer the question about the controversial us e of sequential grafts, we determined the long-term clinical outcome o f patients in whom coronary artery bypass was done with different type s of vein grafts, Methods: A total of 428 consecutive patients who und erwent isolated coronary artery bypass with vein grabs between April 1 , 1976, and April 1, 1977, were prospectively observed, In these patie nts three groups could be defined with single grafts only, sequential grafts only, and combined single and sequential grafts, Follow-up was 99.8% complete and averaged 15.4 years for the survivors, The Kaplan-M eier method and multivariate analysis done with the Cox regression mod el were used for survival, myocardial infarction, reintervention, and ''any event.'' Results: Perioperative mortality and perioperative myoc ardial infarction rate were not statistically different among the thre e groups, During follow-up more myocardial infarctions (hazard ratio: 2.06; 95% confidence interval: 1.08 to 3.93; p = 0.0293) or any events (hazard ratio: 1.54; 95% confidence interval: 1.01 to 2.36; p = 0.045 0) occurred in patients with sequential grafts only than in patients w ith single grafts only, Conclusion: Although more complete revasculari zation was obtained in patients with sequential vein grafts only, more events during a W-year follow-up occurred in these patients than in p atients with single vein grafts only.