Fate of the graft and native vessel following endarterectomy of the left anterior descending coronary artery.

In 16 patients who underwent endarterectomy of the left anterior descending (LAD) coronary artery combined with saphenous vein bypass grafting between Aug. 1, 1976 and July 31, 1978, the results of preoperative and postoperative angiography were comparable. Most patients had obstruction or severe stenosis of the proximal LAD coronary artery together with a poor runoff as demonstrated angiographically. Eighteen vein grafts were placed in the LAD artery and 15 (83%) were satisfactorily patent. Six of 18 grafted arterial segments became occluded distal to the site of graft insertion, but in most cases there was sufficient proximal runoff to maintain graft patency. In this study intraoperative measurements of graft flow were predictive of graft or distal vessel patency, or both. Careful postoperative assessment of the results of this technique seems warranted.