Abstract
We describe an unusual case of an angiographically patent saphenous vein graft to the left anterior descending artery at 51 years post coronary artery bypass grafting surgery in a patient who presents with exertional dyspnea and only relatively recent tobacco-smoking cessation. Factors associated with improved saphenous vein graft patency include the target vessel used for grafting, good distal run-off, and the use of optimal medical therapy alongside aggressive cardiovascular risk-factor modification.