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The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 359-363, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
RN Singh, JA Sosa and GE Green
Thirty-four patients, each receiving internal mammary artery (IMAG) as well
as saphenous vein grafts (SVGs), returned with symptoms 3 to 12 years after
operation and underwent angiographic studies. At a mean follow-up period of
6.8 years, two (6%) IMAGs were occluded and 33 (94%) were in excellent
condition. Of the 57 SVGs, 28 (48%) were totally occluded, 12 (22%) had
severe atherosclerosis, and only 17 (30%) were in good condition. Seven
patients (20%) had new significant lesions in the ungrafted coronary
arteries. Failure of SVGs was the predominant cause of symptoms in this
group of patients. Late failure of the SVGs appears to be due to
progressive atherosclerosis in the grafts. The IMAGs tend to remain free
from atherosclerosis and perform much better than the SVGs in the long run.
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