[Result of sequential coronary artery bypass grafting only with arterial grafts].

The indication of percutaneous transluminal coronary angioplasty is getting wide, and surgical case is getting more severe and more serious. We have, as a rule, performed bypass surgery only with arterial grafts and we have conducted sequential bypass surgery to cope with multiple vessel disease. Coronary artery bypass grafting (CABG) only with arterial grafts was performed in 120 patients from January 1991 to November 1993. Comparison was made between sequential group (n = 20 cases) and non-sequential group (n = 100 cases). The patency rate of sequential group was 98% (39 branches/40 branches). It was 96% (27/28) in the left internal thoracic artery (LITA) sequential group and 100% (12/12) in the right gastroepiplotic artery (RGEA) sequential group. There was no death. The patency rate of non-sequential group was 98% (248/253). It was 98% (95/97) in the LITA group, 97% (60/62) in the right internal thoracic artery (RITA) group, and 99% (93/94) in the RGEA group. Three patients (3%) died in hospital. Operation time, extracorporeal circulation time, and aortic crossclamp time was found to be shorter in the sequential group on two and three vessel bypass surgery. Because the patency rate of sequential bypass were favorable and the operating time could be reduced, sequential bypass method is thought to be usefull in CABG only with arterial grafts.