Late graft patency and symptom relief after aorta-coronary bypass.

One hundred six consecutive patients underwent elective or emergency coronary artery bypass grafting (CABG) between January, 1974, and November, 1975. There were 90 men of an average age of 54 years and 16 women an average of 64 years. Unstable angina (preinfarction angina, angina decubitus, and crescendo angina) was present in 54 patients of this group and eight were in congestive heart failure. Sixty-two of the 106 had previously had myocardial infarctions and four had evolving infarctions. There were four operative deaths (3.8%) and one early hospital death (less than 30 days' hospitalization). Perioperative infarction occurred in five of the survivors. Of the 197 grafts placed in the 101 survivors, 94% were patent by angiography at 1 to 2 weeks (175 of 187 vein grafts and 10 of 10 left internal mammary grafts). At 1 to 2 years after CABG, 62% of the survivors consented to repeat angiography at which time 94% of the grafts were patent (101 of 108 vein grafts and seven of seven left internal mammary grafts). Clinical follow-up of 81 of the 101 survivors at 1 year found 99% of them to be asymptomatic or improved. Repeat clinical follow-up of all survivors (99 of 101) at 3 to 4 years found 93.9% asymptomatic or improved. Overall survival, including operative deaths, was 92.4% at 4 years.