The mechanism and prevention of vein graft failure after coronary artery bypass grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Liaoming , XIERAILI Tiemuerniyazi , SONG Yangwu ,  FENG Wei

1. Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China;

Corresponding author：

FENG Wei, Email: fengwei@fuwai.com

Keywords：

Coronary artery bypass grafting; saphenous vein graft; graft failure; review

DOI：

10.7507/1007-4848.202401046

Video：

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Abstract Full text Figures/Tables Video References Cited by

The saphenous vein graft (SVG) is one of the most commonly used graft in coronary artery bypass grafting. However, SVG failure is very common, significantly impacting patient prognosis. Therefore, effectively preventing SVG failure has become an urgent clinical issue and has garnered widespread attention. This article provides a review of research related to SVG failure, aiming to offer insights for clinical diagnosis, treatment and future studies.

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1. Rocha RV, Tam DY, Karkhanis R, et al. Long-term outcomes associated with total arterial revascularization vs. non-total arterial revascularization. JAMA Cardiol, 2020, 5(5): 507-514.
2. 中国动脉化冠状动脉旁路移植术专家共识组. 中国动脉化冠状动脉旁路移植术专家共识2019版. 中华胸心血管外科杂志, 2019, 35(4): 193-200.
3. Yarlioglues M, Oksuz F, Yalcinkaya D, et al. CHA2DS2-Vasc score and saphenous vein graft disease in patients with coronary artery bypass graft surgery. Coron Artery Dis, 2020, 31(3): 243-247.
4. Gaudino M, Sandner S, An KR, et al. Graft failure after coronary artery bypass grafting and its association with patient characteristics and clinical events: A pooled individual patient data analysis of clinical trials with imaging follow-up. Circulation, 2023, 148(17): 1305-1315.
5. Xenogiannis I, Zenati M, Bhatt DL, et al. Saphenous vein graft failure: From pathophysiology to prevention and treatment strategies. Circulation, 2021, 144(9): 728-745.
6. Yang Y, Zhu Y, Tang C, et al. Predictors of early vein graft failure after off-pump coronary artery bypass grafting: Angiocomputed tomographic results of 233 patients. Eur J Cardiothorac Surg, 2020, 57(2): 277-284.
7. Aydın C, Engin M. The value of inflammation indexes in predicting patency of saphenous vein grafts in patients with coronary artery bypass graft surgery. Cureus, 2021, 13(7): e16646.
8. Parolari A, Cavallotti L, Andreini D, et al. D-dimer is associated with arterial and venous coronary artery bypass graft occlusion. J Thorac Cardiovasc Surg, 2018, 155(1): 200-207.
9. Caliskan E, de Souza DR, Böning A, et al. Saphenous vein grafts in contemporary coronary artery bypass graft surgery. Nat Rev Cardiol, 2020, 17(3): 155-169.
10. Siddiqi S, Ravichandren K, Soltesz EG, et al. Coronary artery bypass graft patency and survival in patients on dialysis. J Surg Res, 2020, 254: 1-6.
11. İyigün T, Kyaruzi MM, Timur B, et al. The predictive effects of clinical hematological changes on saphenous graft patency after coronary artery surgery. Braz J Cardiovasc Surg, 2019, 34(3): 297-304.
12. Yavuz F, Kilic S, Kaplan M, et al. Impact of atherogenic indexes in saphenous vein graft stenosis. Arq Bras Cardiol, 2020, 115(3): 538-544.
13. Nakamura R, Honda K, Kunimoto H, et al. Impact of graft velocity on saphenous vein graft atherosclerosis after coronary artery bypass grafting. Ann Thorac Cardiovasc Surg, 2024, 30(1): 23-00066.
14. Zu ZY, Xu PP, Chen Q, et al. The prognostic value of CT-derived fractional flow reserve in coronary artery bypass graft: A retrospective multicenter study. Eur Radiol, 2023, 33(5): 3029-3040.
15. Toth GG, De Bruyne B, Kala P, et al. Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: The GRAFFITI trial. EuroIntervention, 2019, 15(11): e999-e1005.
16. Thuesen AL, Riber LP, Veien KT, et al. Fractional flow reserve versus angiographically-guided coronary artery bypass grafting. J Am Coll Cardiol, 2018, 72(22): 2732-2743.
17. Dacey LJ, Braxton JH, Kramer RS, et al. Long-term outcomes of endoscopic vein harvesting after coronary artery bypass grafting. Circulation, 2011, 123(2): 147-153.
18. Lopes RD, Hafley GE, Allen KB, et al. Endoscopic versus open vein-graft harvesting in coronary-artery bypass surgery. N Engl J Med, 2009, 361(3): 235-244.
19. Zenati MA, Bhatt DL, Bakaeen FG, et al. Randomized trial of endoscopic or open vein-graft harvesting for coronary-artery bypass. N Engl J Med, 2019, 380(2): 132-141.
20. Li G, Zhang Y, Wu Z, et al. Mid-term and long-term outcomes of endoscopic versus open vein harvesting for coronary artery bypass: A systematic review and meta-analysis. Int J Surg, 2019, 72: 167-173.
21. Desai P, Kiani S, Thiruvanthan N, et al. Impact of the learning curve for endoscopic vein harvest on conduit quality and early graft patency. Ann Thorac Surg, 2011, 91(5): 1385-1391.
22. Tian M, Wang X, Sun H, et al. No-touch versus conventional vein harvesting techniques at 12 months after coronary artery bypass grafting surgery: Multicenter randomized, controlled trial. Circulation, 2021, 144(14): 1120-1129.
23. Dreifaldt M, Mannion JD, Geijer H, et al. The no-touch saphenous vein is an excellent alternative conduit to the radial artery 8 years after coronary artery bypass grafting: A randomized trial. J Thorac Cardiovasc Surg, 2021, 161(2): 624-630.
24. Samano N, Souza D, Pinheiro BB, et al. Twenty-five years of no-touch saphenous vein harvesting for coronary artery bypass grafting: Structural observations and impact on graft performance. Braz J Cardiovasc Surg, 2020, 35(1): 91-99.
25. Weiss MG, Nielsen PH, James S, et al. Clinical outcomes after surgical revascularization using no-touch versus conventional saphenous vein grafts: Mid-term follow-up of propensity score matched cohorts. Semin Thorac Cardiovasc Surg, 2023, Summer,35(2): 228-236.
26. Zivkovic I, Krasic S, Stankovic M, et al. Influence of three different surgical techniques on microscopic damage of saphenous vein grafts: A randomized study. Medicina (Kaunas), 2023, 59(2): 217.
27. Yokoyama Y, Shimamura J, Takagi H, et al. Harvesting techniques of the saphenous vein graft for coronary artery bypass: Insights from a network meta-analysis. J Card Surg, 2021, 36(11): 4369-4375.
28. Vuong NL, Elfaituri MK, Eldoadoa M, et al. Saphenous vein harvesting techniques for coronary artery bypass grafting: A systematic review and meta-analysis. Coron Artery Dis, 2022, 33(2): 128-136.
29. Katayama Y, Miho T, Nogami E, et al. Endoscopic pedicle saphenous vein graft harvesting. Ann Thorac Cardiovasc Surg, 2024, 30(1): 23-00054.
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