[Long-term evaluation of aorto-coronary bypass surgery]

Between October 1969 and June 1978; 878 patients underwent coronary bypass grafting at Harefield Hospital. Five hundred and fifty-four patients (63%) were restudied postoperatively by coronary angiography in order to evaluate graft patency in relation to time, runoff, influence of endoarterectomies, clinical condition, age, sex, risk factors and the progression of the disease in native vessels. Patency rate was 85% in 197 patients restudied between 1 and 6 years postoperative (mean 26 months). Patency rate of 63 endoarterectomized vessel restudied between 1 and 6 years postoperatively was 84%. Restudy of 343 patent grafts shows a good runoff in 299 (87%). The effects of runoff on long term patency were evaluated in a group of 81 patients restudied twice with mean interval of 18.3 months between the first and second investigation. Eighty-six percent of 147 grafts showed a good runoff at the second study. Age, sex and risk factors do not appear to influence long term patency rate. Two hundred and sixty out of 354 patients followed up postoperatively from 6 to 86 months (mean 28.2 months) were asymptomatic and the graft patency rate was 87%. Seventy-four of these patients had all their grafts patent. Sixteen symptomatic patients had a patency rate of 55%, thirty-seven percent of them had all the grafts patent. Progression of the disease in native vessels was observed in 23 out of 132 non grafted vessels (17%) and distal to the graft in 7 out of 252 bypassed vessels (3%).