Coronary-Artery Bypass Surgery with Internal-Thoracic-Artery Grafts

To the Editor: On the basis of data collected from the Coronary Artery Surgery Study (CASS) registry, Cameron and coworkers (Jan. 25 issue) 1 conclude that as compared with saphenous-vein coronary bypass grafts, internal-thoracic-artery (ITA) grafts conferred a survival advantage after 15 years of follow-up. These results are consistent with previously published data 2 that showed improved survival among patients who received ITA grafts and are supported by angiographic and pathological studies that demonstrated higher patency rates for these conduits, as compared with saphenous-vein grafts. Regrettably, Cameron et al. did not include in their analysis several important variables that may have influenced . . .