What is a disadvantage of a saphenous vein graft?

• A. Always lasts a lifetime.
• B. Never deteriorates.
• C. Improves heart function only with medications.
• D. May deteriorate in 5-7 years.

Answer: (D)

The main issue is long-term durability. Saphenous vein grafts, once placed in the arterial system, are exposed to higher pressures and flow than veins are meant to handle. This stress can damage the endothelium, trigger intimal hyperplasia, and promote accelerated atherosclerosis, leading to gradual narrowing or occlusion. Because of these processes, deterioration of the graft commonly becomes evident within the 5- to 7-year window after surgery, making this a key disadvantage compared with arterial grafts, which tend to stay patent longer.

In contrast, the other statements aren’t accurate: a vein graft does not last a lifetime and can deteriorate over time; heart function improvement isn’t achieved solely by medications—the graft itself provides the bypass conduit; and while medications help manage symptoms and risk factors, they don’t prevent the graft’s inherent long-term decline.