Extensive use of arterial grafts for coronary artery bypass grafting in Japanese patients.

Between August 1985 and December 1992, 298 patients underwent coronary artery bypass grafting with two or more distal anastomoses using arterial grafts. There were 279 males and 19 females, with an average age of 58.4 years. Thirty-one patients underwent sequential bypass with the left internal mammary artery. The remaining 267 patients received two or more arterial grafts. The three major combinations were the left and right internal mammary arteries (120 cases), the left internal mammary and right gastroepiploic arteries (100 cases) and the left and right internal mammary and right gastroepiploic arterial (43 cases). An additional saphenous vein bypass was constructed in 113 patients, and the average number of distal anastomoses was 2.70 per patient. The operative mortality rate was 1.0% (three patients), and hospital mortality rate 0.7% (two patients). Angiographic patency rate was 97.9% in arterial grafts and 94.3% in venous grafts. There were seven late deaths (three due to cardiac causes), and the 7-year actuarial survival and event-free rates were 92.8% and 86.6%, respectively. In conclusion, the extensive usage of arterial grafts in Japanese patients was accompanied by excellent long-term results without increased operative mortality and morbidity.