Aortocoronary Saphenous-Vein Bypass

Abstract

To assess the effect of saphenous-vein bypass grafting on resting ventricular performance, left ventricular volumes and ejection fraction were measured before and after surgery in 40 patients. Symptomatic improvement occurred in 80 per cent (32 of 40), maximal treadmill exercise performance improved in 50 per cent (15 of 30) (p<0.05), and ischemic ST-segment response to exercise disappeared in 78 per cent (14 of 18). There were no significant changes in end-diastolic volume, end-systolic volume or systolic ejection fraction for the group as a whole after saphenous-vein bypass grafting or in subgroups with all patent grafts (28), no myocardial infarction (20) or total revascularization (18). Left ventricular contraction plots were unchanged after operation in 63 per cent (25 of 40), improved in 15 per cent (six of 40) and worse in 22 per cent (nine of 40). We conclude that saphenous-vein bypass grafting does not consistently improve left ventricular performance. (N Engl J Med 290:186–192, 1974)