Long-term serial angiographic studies after coronary artery bypass surgery.

Twenty-six patients underwent repeat coronary angiography 5--8 years after saphenous vein coronary artery bypass surgery (SVCABG). These patients were selected from the first cohort of 117 patient who had SVCABG because they had obtained essentially complete relief of angina, and because all grafts were patent at initial angiography 11.2 months (mean) after surgery. Of the 39 grafts (1.5 grafts per patient) patent at 1 year, 34 (87.2%) were patent at reexamination 76 months (mean) (range 65--103 months) after SVCABG. Graft occlusion could not be predicted by the early angiographic appearance of the graft itself or its proximal or distal anastomosis. In some cases, narrowing or irregularity consistent with intimal hyperplasia appeared to progress, while in others it developed at late follow-up. Progressive narrowing occurred in 96% (22 of 23 grafted vessels) of the native coronary arteries proximal to the graft anastomosis. Progresssion to a stenosis greater than 75% or total occlusion was seen distal to t...