[Nonevolutive aspect of changes in aortocoronary grafts]

An accurate and objective knowledge of the evolution of the aorta-to-coronary grafts is essential in order to establish the rationale of the role of this surgery in the treatment of the coronary artery disease. Serial angiographies of the venous grafts were performed 15 days, one year and approximately 3 years after operation in 74 patients (101 grafts). The graft occlusion rate was 10% in the initial study, more than 20% in the second examination and 6% in the third examination. Moreover, a significant number of pervious grafts have shown, between 2 weeks and one year, a diffuse or segmentary reduction of their lumen. Nevertheless, besides a few grafts with severe stenoses which became occluded, these changes did not progress between one and three years. Therefore, sub-intimal fibrous hyperplasia, responsible for the structure changes of the grafts, does not seem to be a slowly evolutive pathologic process but seems rather to stabilize itself after one year.