Coronary graft failure

Abstract

Coronary artery bypass grafting is the most common major surgical procedure in the world. To restore blood flow to the affected myocardium, a vessel from another part of the body is procured to create a bypass around a critically stenosed coronary artery. The internal thoracic artery remains the conduit of “gold standard” due to its superior long-term patency. However, almost all patients require additional grafts to provide a complete revascularization. This necessitates the harvest of other vessels, most commonly the saphenous vein and/or radial artery.
Long-term graft patency and consequently improving the quality and life expectancy of patient is the primary aim of coronary artery bypass surgery. Graft failure is a complex, multifactorial event that occurs in a substantial proportion of conduits. The main factors of both early and late graft failure continue to be studied to this day. This review presents data on biochemical, technical, systemic and local factors associated with graft failure, as well as methods for early detection of predictors of graft failure.