ANGIOGRAPHIC PREDICTORS OF GRAFT PATENCY AND DISEASE PROGRESSION AFTER CORONARY-ARTERY BYPASS-GRAFTING WITH ARTERIAL AND VENOUS GRAFTS

Background. There are few data about angiographic determinants of func tional graft patency and native artery disease progression after coron ary artery bypass grafting operation with arterial grafts compared wit h venous grafts. Methods. Baseline and follow-up coronary angiograms a t a mean of 2 years after operation in 91 patients with 194 arterial a nd 204 venous graft anastomoses were analyzed. Results. Ninety-two per cent of the arterial and 87% of the venous graft anastomoses were pate nt at follow-up angiography (p = 0.05, odds ratio = 2.63). Unlike that of arterial grafts, the patency rate of venous graft anastomoses corr elated negatively with decreasing severity of the bypassed lesion. In contrast to venous grafts, in which angiographic graft function was ba sically dichotomous (fully patent or occluded), compromised now of the arterial graft anastomoses was registered in 12%. Progression of the disease was more common in segments bypassed with venous grafts than w ith arterial grafts (p = 0.001, odds ratio = 2.03). Conclusions. Angio graphic determinants of functional graft patency and progression of oc clusive changes in the bypassed artery segments are different for arte rial and venous grafts. (Ann Thorac Surg 1998;66:1289-94) (C) 1998 by The Society of Thoracic Surgeons