Total arterial coronary bypass: long-term results

Three groups of consecutive patients who had undergone primary elective coronary artery bypass operations were compared at 10 to 20 years of follow-up (mean, 13.6 years), in order to test the supposition that arterial conduits provide better long-term outcome than do the "standard" left internal mammary-to-left anterior descending coronary artery plus saphenous vein bypasses. The arterial group was split into groups A (all arterial) and B (2 or more arterial grafts, plus saphenous vein grafts). Control group C comprised the standard operations. The absence of saphenous vein conduit in group A was associated with fewer angiograms for symptoms, fewer reinterventions, and fewer cardiac deaths than those experienced in groups B and C. We conclude that the survival and cardiac quality-of-life advantage found in group A is attributable to the exclusive use of arterial conduits.