To evaluate longterm survival, 1041 consecutive patients with aorto-coronary bypass operations were followed for a mean of 7.5 years (range 5 to 14.5). The peri-operative mortality was 12 (1.2%). Of the 131 late deaths, 97 (74%) were cardiac in origin. The survival probability at 5 years was 92 +/- 2% and at 10 years 79 +/- 4%. Figures for a matched general Dutch population are 94% and 87%, respectively. Stepwise multivariate analysis revealed an association between death rate and impaired left ventricular function (rate ratio impaired function versus normal: 1.82, P = 0.0007) and extent of vascular disease (rate ratio 3 vessel-versus 1 vessel disease: 1.80, P = 0.01) while no relation was found with sex or age at operation. Surgery seems to provide a good probability of survival, although in patients with extensive vascular involvement and/or a decreased left ventricular function at the time of operation, the longterm outlook is less favourable than for those without these characteristics.