[A study of the long-term graft patency using a saphenous vein graft following aorto-coronary bypass surgery].

Long term graft patency after aorto-coronary (A-C) bypass surgery has been reported in the West and the data shows a lower patency rate in saphenous vein grafts (SVG) than internal mammary artery grafts. We studied the long term SVG patency in cases of Japanese patients at our institute, and we have compared our results with those in the West. The subjects, including children, were 211 cases who received A-C bypass surgery using at least one SVG from Jan., 1975 to Sept., 1989. 182 of these cases (examination rate: 86%) received a postoperative angiography one or three months after surgery. The postoperative study took the form of either a selective coronary angiography or a digital subtraction angiography. In 81 cases, using the same two methods, graft patency was reconfirmed from one to eleven years after surgery. Early graft patency including children was 95%. Long term graft patency in the adult cases was 89% from 1 to 2 years (mean: 1.3 years), 94% from 2 to 5 years (mean: 3.2 years), 88% from 6 to 11 years (mean: 7.1 years) following the operation. Six patients died during the post operative follow up period. Two cases were sudden death, one resulted from a reoperation for recurrent angina, two were caused by malignant neoplasm and other was the result of a cerebro-vascular accident. The results correlating the long term graft patency using a SVG and long term mortality were not as negative at our institute as they have been in studies done in the West.