Angiographic Appearance of Patent Saphenous Vein Graft 32 Years After Coronary Artery Bypass Grafting

A 76-year-old man presented with chest pain. Coronary artery angiography showed a patent saphenous vein graft (SVG) with good run-off to the native coronary artery 32 years after coronary artery bypass grafting (CABG; Figure). Body mass index was 18.4 kg/m² and the patient had a medical history of hypertension, diabetes mellitus, and dyslipidemia that were strictly controlled by medication after surgery. He had also maintained smoking cessation after surgery. The patent SVG was harvested in the standard manner and sequentially bypassed to the first diagonal branch and left anterior descending artery (LAD). He had no history of additional coronary artery intervention to the SVG. This SVG was diagnosed as FitzGibbon classification AI.¹ This rare case showing the angiographic appearance of a 32-year-old patent SVG demonstrates that sequential SVG including a good run-off LAD followed by strict postoperative medication, the cessation of smoking, and weight control after CABG may have contributed to the longevity of SVG.

Figure.

Patent saphenous vein graft 32 years after surgery, which was sequentially bypassed to the first diagonal branch and left anterior descending artery with good run-off.

Disclosures

The authors declare no conflicts of interest.

Reference

• 1.   FitzGibbon GM, Kafka HP, Leach AJ, Keon WJ, Hooper GD, Burton JR. Coronary bypass graft fate and patient outcome: Angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years. J Am Coll Cardiol 1996; 28: 616–626.