Distribution and severity of atherosclerosis in the coronary arteries.

A postmortem study of 93 human hearts was undertaken. Gross inspection was used to determine the degree of atherosclerosis and postmortem coronary angiography to estimate the degree of luminal narrowing. The findings indicate the following: (1) There is high correlation between the estimates of luminal narrowing in the gross specimen and the presence of significant atherosclerosis. (2) Approximately 30 per cent of vessels with significant proximal disease will have significant distal coronary artery disease. (3) When one coronary artery is involved with severe proximal atherosclerosis, either of the other two vessels are likely to be involved, with a frequency of 75 per cent ormore. (4) When significant distal disease is present the proximal vessel is nearly always involved. (5) Patient selection prior to referral to surgery may be partly responsible for the over 90 per cent operability rate in patients undergoing coronary artery bypass grafting.