The fate of arm veins used for aorta-coronary bypass grafts.

Arm veins have been a common second choice conduit for those patients having insufficient saphenous veins for coronary bypass operations. To define the patency and durability of arm vein grafts, we reviewed our patients with one or more arm vein grafts used for coronary revascularization between 1974 and 1982. A total of 59 patients required at least one arm vein graft and 51 are presently alive. Postoperative arteriograms were obtained in 28 patients. Of 56 arm vein grafts used, 32 (57%) were patent and 24 (43%) had failed at 2 years. Seven of the patent grafts had a localized area of stenosis. Sixteen internal mammary artery grafts also had been used in this group of patients, and 15 (93%) were patent. We conclude that arm vein grafts have a high failure rate and are not as dependable as saphenous vein grafts or internal mammary artery grafts.