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November 13, 1996

Aortocoronary Bypass With Saphenous Vein Graft

Author Affiliations

From the Department of Surgery, St Louis University Health Sciences Center, St Louis, Mo.

JAMA. 1996;276(18):1521-1525. doi:10.1001/jama.1996.03540180077039

THE 1973 report by Garrett, Dennis, and DeBakey1 on the long-term patency of an aortocoronary saphenous vein bypass graft established at an operation 9 years previously (November 1964) identifies a high plateau that had been reached in the search for a means to improve blood flow to the myocardium in the presence of flow-limiting coronary atherosclerosis. Few medical interventions have gained such investigative and clinical dominance as those procedures increasing blood flow to the heart. Now, 20 years subsequent to the demonstrated capability, close to a million procedures are performed annually in this country alone. This is especially remarkable considering that these procedures are not curative of the disease but treat only the consequences, termed by Lewis Thomas2 as "half way technology."

The malady, coronary artery occlusive disease, remains the leading cause of death in Western cultures in spite of rigorous attempts to control the alterable risk factors