Long-term information is available on some patients who had CABG in the early 1970s. By ten years substantial progression of disease is present in both the native coronary circulation and in the bypass grafts. Investigators have reported that as many as two-thirds of vein bypass grafts are closed or narrowed and intrinsic coronary disease has progressed in as many as one-half of non-bypassed vessels at 10 years following surgery. The timing of surgery in less severely symptomatic patients, strategies to decrease disease progression in grafted vessels and native circulation, and renewed interest in the use of the internal mammary artery to revascularize the heart are very active research issues at present.