Abstract
We report a case of competitive blood flow in the left coronary circulation after saphenous vein bypass grafting that resulted in the apparent progression of a proximal stenosis to total occlusion at coronary angiography. Repeat angiography with careful attention to catheter position and adequate injection of contrast agent demonstrated the actual anatomy and showed that there was no postoperative change in the native coronary circulation. The true incidence of progression of proximal coronary disease after saphenous vein bypass surgery is unknown, and reported figures may be falsely elevated because of unrecognized competitive flow patterns simulating obstruction.
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