Angiographic determination of operability in candidates for aorto-coronary bypass.

Abstract

The results of venous bypass operations upon 57 diseased coronary arteries have been studied, using pre and postoperative angiography.An attempt was made to determine if the angiographically demonstrated caliber of the poststenotic distal segment of the artery was of any significance in deciding which patients were suitable candidates for bypass surgery.Among the 47 arteries having a distal lumen diameter of greater than 1 mm., a 91 per cent graft patency rate was achieved. Among the 10 arteries having a distal lumen diameter of 1 mm. or less, only a 30 per cent graft patency rate could be achieved.Thus it would appear that the coronary arteriogram gives an accurate indication of the actual caliber of the distal segment and that where this is 1 mm. or less, diffuse atherosclerosis is likely to be present, making the outlook for a bypass operation rather unfavorable.