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Long-Term Clinical Outcome Following CABG

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Coronary Graft Failure

Abstract

Long-term results of aorto-coronary bypass surgery (CABG) are studied in numerous trials and meta-analyses, still presenting several, unresolved issues related to the type of graft (venous or arterial), cardiac performance, risk factors and other preexisting comorbidities (peripheral arteritis, carotid stenosis, renal and hepatic dysfunction, stroke, etc.). Noninvasive imaging techniques such as multislice computed tomography angiography (CTA) (64-128-256 row), CT64 coronary screening, magnetic resonance angiography (MRA), single photon emission tomography (SPET), and transthoracic and transesophageal Doppler echocardiography allow periodic evaluations of graft patency with similar results when compared with data obtained by coronary angiography. Arterial grafts, especially left internal mammary artery (LIMA), ensure longer permeability compared to the venous grafts. Given that interventional cardiology made great progress in complex lesion revascularization, surgical intervention is considered mainly in case of undilatable lesions, thus resolving the “stent or surgery” problem. It is, however, acknowledged that the permeability of bypass grafts is longer than that of conventional stents. Long-term monitoring of patients with coronary lesions treated surgically is difficult because these patients are usually older than 50 years and have associated diseases that can cause death unrelated to the permeability of grafts.

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Authors and Affiliations

  1. Cardiac Surgery Department, Institute of Cardiovascular Medicine, Timisoara, Timis, Romania

    Marian Gaspar MD, PhD

  2. Department of Cardiovascular Surgery, “Vasile Goldis” Western University of Arad, Arad, Arad, Romania

    Francisca Blanca Călinescu MD, PhD

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  1. Marian Gaspar MD, PhD
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Correspondence to Marian Gaspar MD, PhD .

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Editors and Affiliations

  1. Cardiology, Army's Center for Cardiovascular Di, Bucharest, Romania

    Ion C. Ţintoiu

  2. Department of Surgery, Chinese University of Hong Kong, Sha Tin, Hong Kong

    Malcolm John Underwood

  3. University Fribourg, Hospital HFR Fribourg, Fribourg, Fribourg, Switzerland

    Stephane Pierre Cook

  4. Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan

    Hironori Kitabata

  5. University Medical Center, Texas Tech Univ. Health Science Center, EL PASO, Texas, USA

    Aamer Abbas

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Gaspar, M., Călinescu, F.B. (2016). Long-Term Clinical Outcome Following CABG. In: Ţintoiu, I., Underwood, M., Cook, S., Kitabata, H., Abbas, A. (eds) Coronary Graft Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-26515-5_20

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