Occlusive changes in the intrinsic coronary arterial circulation were found in 50 of 71 patients 6.1 ± 0.8(± S.E.M.) after saphenous-vein bypass surgery. A new total arterial occlusion was found in 57 (30 per cent) of 188 major coronary arteries. These occlusions occurred in 29 per cent (20 of 68) of intrinsic coronary arteries with a patent graft, in 62 per cent (24 of 39) of those with an occluded graft, and in 16 per cent (13 of 81) of arteries not bypassed. A comparable reduction in segmental left ventricular motion was noted. Eighty-six per cent of the 71 patients had symptomatic improvement of angina; 60 per cent were asymptomatic. Thus, change in the intrinsic coronary circulation after bypass procedures is not inconsistent with relief of angina and must be considered in the evaluation of this operation.
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