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November 1978

Arterial Grafts: Past, Present, and Future

Author Affiliations

From the Department of Surgery, University of New Mexico School of Medicine, Albuquerque.

Arch Surg. 1978;113(11):1225-1233. doi:10.1001/archsurg.1978.01370230015001

History is an esoteric exercise unless we use it to guide our future. I should therefore like to record the recent history of arterial grafts from a personal vantage point, paying particular attention to the mistakes I have made and the lessons I have learned. Finally, I would like to use this experience to point out the directions I think we should go, especially in the development of small-caliber grafts for coronary bypass and distal leg arteries.

INITIAL GRAFT ATTEMPTS  Forty years elapsed between the demonstration by Carrel and Guthrie1.2 that homologous and heterologous veins and arteries could serve as arterial grafts in experimental animals and their first use in man. Modern arterial surgery began its logarithmic growth in 1948, just 30 years ago, when Gross et al3 demonstrated that arterial allografts could be preserved and used satisfactorily in humans. In his development of surgery for coarctation in