Study objective: To determine the angiographic patency of cryopreserve
d saphenous vein grafts used as conduits during coronary artery bypass
surgery and whether this is affected by postoperative immunosuppressi
ve therapy. Design ana setting: A retrospective review of medical reco
rds and coronary angiograms of patients at a university hospital. Pati
ents: Eleven patients undergoing 12 coronary artery bypass operations
during which a total of 26 distal coronary anastomoses were created us
ing cryopreserved vein grafts. Measurements: Eight postoperative coron
ary angiograms were performed in 10 patients surviving longer than 1 w
eek. All angiograms were performed on the basis of symptoms of suspect
ed myocardial ischemia. Angiographic results, postoperative anticoagul
ation, and therapy with immunosuppressive agents were analyzed.Results
: Seventeen cryopreserved vein grafts were studied; one (6%) was paten
t, 12 (71%) were occluded, and 4 (23%) were stenosed. In patients trea
ted with azathioprine, seven of the eight cryopreserved vein grafts we
re occluded, In patients not receiving immunosuppression, five were oc
cluded, three were stenosed, and one was patent. Bu internal mammary g
rafts were widely patent. Conclusion: Cryopreserved vein grafts have a
poor angiographic patency which did not appear to be affected by immu
nosuppressive therapy with azathioprine, The use of this graft should
be restricted and alternative arterial conduits utilized.