Results of direct coronary artery graft reconstruction. A five-year clinical and arteriographic appraisal.

Three hundred thirty-six patients with severe coronary artery disease were operated upon between June, 1969, and December, 1974. All were followed from 1 to 66 months (average, 37 months) with respect to survival and late myocardial infarction. The patients operated upon were compared statistically with a group of unoperated patients, and this evaluation demonstrated significantly better late survival in the surgically treated patients who had double- and triple-vessel disease. Two hundred thirty-six consecutive patients had clinical and late arteriographic reevaluation more than 6 months postoperatively; 78% were asymptomatic. Factors affecting graft patency are reviewed in detail. Late graft patency is determined by preoperative selection of vessels for grafting. Patency is not an index of success for this procedure. Surgical therapy appears to be the treatment of choice for patients with two- three-vessel coronary occlusive disease.