The significance of coronary topography for operative technique and tactics in multiple myocardial revascularization with jump-grafts.

Aortocoronary bypass procedures for proximal lesions are accepted with widely documented excellent results, but are still controversial in their application for diffuse disease. However, failures of the single graft technique to small coronary branches with marginal flows are markedly reduced by the jump technique. In our experience with 447 angiographic controls from April 1978 to December 1980, the jump-graft patency rate was 87.8% versus 84.9% for single grafts, and as high as 96.3% in the subgroup of multiple jumps (sequential grafts). The sequence of the anastomoses as far as the individual flow is concerned significantly influences the results of the jump-graft technique.