Coronary artery bypass grafting with saphenous vein

Occlusion rate of the saphenous vein is around 12-20% during the 1st year and 2-4% annually for the next 4 or 5 years. Subsequently, this rate doubles, so that at 10 years, approximately 50% of grafts become occluded due to the occurrence of graft atherosclerosis. A similar percentage of patent grafts show atherosclerotic changes at the end of the 1st decade. Sequential vein grafts probably suffer the same fate although late follow-up is lacking. Reoperation is estimated to be 30% at 10 years, as judged by angiographic criteria. The operative risk of reoperation is at least double that of primary operation; symptomatic relief appears to be of shorter duration. Recent technical changes to better preserve medial and endothelial function and to pharmacologically inhibit platelet function may lead to longer duration of the venous conduit.