Objective: To evaluate the patency of saphenous vein and internal thoracic artery grafts by coronary system using angiographies performed in symptomatic patients after coronary artery bypass grafting.
Material and methods: From 1999 to 2006, 685 patients (mean age, 59.1+/-11.8 years) had angiography of 538 internal thoracic and gastroepiploic artery and 1644 saphenous vein grafts. There were 580 (84.7%) males. The mean period from operation to the performance of reangiogram was 73.3+/-53.5 months. Graft failure was defined as >95% stenosis. The saphenous vein was grafted to the left anterior descending artery in 106 (6.4%), to the diagonal artery in 364 (22.1%), to the obtuse marginal artery in 629 (38.3%), and to the right coronary artery in 545 (33.1%) cases.
Results: During the study, 1496 (68.97%) grafts were patent, and 686 (31.0%) had failed. Unadjusted 1-, 5-, 10-, and >10-year patency was 91.0%, 89.9%, 90.1%, and 75% for internal thoracic arteries and 79.9%, 68.6%, 57.4%, and 51.0% for saphenous veins, respectively.
Conclusions: Internal thoracic arteries demonstrate better patency than saphenous veins except when grafting moderately stenosed coronary arteries. When bypassing coronary arteries with less than 70% stenosis, saphenous veins may be a better choice.