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Ask the doctor: How long will my bypass grafts last?

Ask the doctor

How long will my bypass grafts last?

Q. Three years ago I had coronary bypass surgery. How long will my grafts last?

A. It depends on where your grafts came from. The most common sources are leg veins (the saphenous vein), arteries that supply the chest (the internal mammary artery), and arteries from the arm (the radial artery). Grafts made from leg veins tend to become blocked by cholesterol-filled plaque and blood clots over time, so that half or more close up within 10 years. Grafts made from internal mammary arteries resist such blockages, and most stay open for 20 years or more. Grafts made from radial arteries fall somewhere in between.

Why aren’t internal mammary arteries used for all bypass grafts? For one thing, each of us is born with only two of these, and many people need two, three, or more bypass grafts. Using both internal mammary arteries could compromise blood supply to the chest wall. In addition, they are relatively short, usually reaching only the front part of the heart. That’s why most people have their blockages bypassed with a combination of internal mammary and saphenous vein or radial artery grafts.

If you have vein grafts, don’t feel like your clock is ticking based on these numbers. In many people, as vein grafts narrow, the heart responds by growing new blood vessels that can compensate for the reduced blood flow. One thing you can do to nurture the growth of these collateral vessels is exercise regularly. If you do this and take care of your heart in other ways, the chances are good that even if your vein graft blocks, neither you nor your heart will notice it.

— Thomas Lee, M.D. Editor in Chief, Harvard Heart Letter

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Last updated:	August 22, 2006