• Steven Goldman, Karen Zadina, Thomas Moritz, Theron Ovitt, Gulshan Sethi, Jack G Copeland, Lizy Thottapurathu, Barbara Krasnicka, Nancy Ellis, Robert J Anderson, William Henderson, and VA Cooperative Study Group #207/297/364.
• Southern Arizona VA Health Care System and the University of Arizona Sarver Heart Center, Tucson, Arizona, USA. steven.goldman@med.va.gov
• J. Am. Coll. Cardiol. 2004 Dec 7; 44 (11): 2149-56.

ObjectivesThis study defined long-term patency of saphenous vein grafts (SVG) and internal mammary artery (IMA) grafts.BackgroundThis VA Cooperative Studies Trial defined 10-year SVG patency in 1,074 patients and left IMA patency in 457 patients undergoing coronary artery bypass grafting (CABG).MethodsPatients underwent cardiac catheterizations at 1 week and 1, 3, 6, and 10 years after CABG.ResultsPatency at 10 years was 61% for SVGs compared with 85% for IMA grafts (p < 0.001). If a SVG or IMA graft was patent at 1 week, that graft had a 68% and 88% chance, respectively, of being patent at 10 years. The SVG patency to the left anterior descending artery (LAD) (69%) was better (p < 0.001) than to the right coronary artery (56%), or circumflex (58%). Recipient vessel size was a significant predictor of graft patency, in vessels >2.0 mm in diameter SVG patency was 88% versus 55% in vessels ConclusionsThe 10-year patency of IMA grafts is better than SVGs. The 10-year patency for SVGs is better and the 10-year patency for IMA grafts is worse than expected. The 10-year patency of SVGs to the LAD is better than that to the right or circumflex. The best long-term predictors of SVG graft patency are grafting into the LAD and grafting into a vessel that is >2.0 mm in diameter.

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