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The Management of Intractable Angina Pectoris Using Saphenous Vein Bypass Grafts
Abstract
Between 1970 and 1972, 54 patients with obstructive coronary artery disease had 84 saphenous vein bypass grafts performed. There was a 7% operative and a 14% late mortality. Significant symptomatic improvement occurred in 93% of the survivors and 63% were totally relieved of angina; 76% of the grafts were patent at the time of recatheterisation. No correlation between the graft patency rate and size of grafted vessels - the extent of peripheral run-off or flow rate at the time of grafting - could be demonstrated. Saphenous vein bypass grafting appears to have a place in the management of intractable angina pectoris in the relatively small group whose vessels appear suitable for grafting. There was little evidence of improvement in left ventricular function, and surgery is contra-indicated when left ventricular function is severely impaired. The superiority of surgical treatment over conservative medical management of patients with less severe disease and in the pre-infarction or crescendo anginal syndrome, remains to be demonstrated.
