Author + information
- Received May 6, 2004
- Revision received August 16, 2004
- Accepted August 25, 2004
- Published online December 7, 2004.
- Steven Goldman, MD, FACC*,* (, )
- Karen Zadina, RN, MA*,
- Thomas Moritz, MS†,
- Theron Ovitt, MD*,
- Gulshan Sethi, MD*,
- Jack G. Copeland, MD*,
- Lizy Thottapurathu, MS†,
- Barbara Krasnicka, PhD†,
- Nancy Ellis, MS†,
- Robert J. Anderson, PhD†,
- William Henderson, PhD†,
- VA Cooperative Study Group #207/297/364
- ↵*Reprint requests and correspondence:
Dr. Steven Goldman, Cardiology Section (1-111C), Southern Arizona VA Health Care System, 3601 South 6th Avenue, Tucson, Arizona 85723
Objectives This study defined long-term patency of saphenous vein grafts (SVG) and internal mammary artery (IMA) grafts.
Background This VA Cooperative Studies Trial defined 10-year SVG patency in 1,074 patients and left IMA patency in 457 patients undergoing coronary artery bypass grafting (CABG).
Methods Patients underwent cardiac catheterizations at 1 week and 1, 3, 6, and 10 years after CABG.
Results Patency at 10 years was 61% for SVGs compared with 85% for IMA grafts (p < 0.001). If a SVG or IMA graft was patent at 1 week, that graft had a 68% and 88% chance, respectively, of being patent at 10 years. The SVG patency to the left anterior descending artery (LAD) (69%) was better (p < 0.001) than to the right coronary artery (56%), or circumflex (58%). Recipient vessel size was a significant predictor of graft patency, in vessels >2.0 mm in diameter SVG patency was 88% versus 55% in vessels ≤2.0 mm (p < 0.001). Other positive significant predictors of graft patency were use of aspirin after bypass, older age, lower serum cholesterol, and lowest Canadian Functional Class (p < 0.001 to 0.058).
Conclusions The 10-year patency of IMA grafts is better than SVGs. The 10-year patency for SVGs is better and the 10-year patency for IMA grafts is worse than expected. The 10-year patency of SVGs to the LAD is better than that to the right or circumflex. The best long-term predictors of SVG graft patency are grafting into the LAD and grafting into a vessel that is >2.0 mm in diameter.
Supported by the Cooperative Studies Program of the Department of Veterans Affairs Research and Development Service, Washington, DC.
- Received May 6, 2004.
- Revision received August 16, 2004.
- Accepted August 25, 2004.
- American College of Cardiology Foundation