Universität zu Köln

Caliskan, Etem ORCID: 0000-0002-9051-7841, De Souza, Domingos Ramos, Boening, Andreas, Liakopoulos, Oliver J., Choi, Yeong-Hoon, Pepper, John, Gibson, C. Michael, Perrault, Louis P., Wolf, Randall K., Kim, Ki-Bong and Emmert, Maximilian Y. (2020). Saphenous vein grafts in contemporary coronary artery bypass graft surgery. Nat. Rev. Cardiol., 17 (3). S. 155 - 170. NEW YORK: NATURE PUBLISHING GROUP. ISSN 1759-5010

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Abstract

Myocardial ischaemia resulting from obstructive coronary artery disease is a major cause of morbidity and mortality in the developed world. Coronary artery bypass graft (CABG) surgery is the gold-standard treatment in many patients with complex multivessel coronary artery disease or left main disease. Despite substantial improvements in the outcome of patients undergoing CABG surgery in the past decade, graft patency remains the 'Achilles' heel' of this procedure. Whereas the use of the left internal mammary artery as a conduit is associated with the highest 10-year patency rate (>90%), saphenous vein grafts - the most commonly used conduit in CABG surgery - fail in 40-50% of treated patients by 10 years after surgery. Vein graft disease (VGD) and failure result from complex pathophysiological processes that can lead to complete occlusion of the graft, affecting long-term clinical outcomes. Optimal harvesting techniques, intraoperative preservation strategies and intraoperative patency control have important roles in the prevention of VGD. In addition, several studies published in the past decade have reported similar mid-term patency rates between vein grafts and arterial grafts when veins are used as a composite graft based on the internal mammary artery. In this Review, we present the latest evidence on the utilization of saphenous vein grafts for CABG surgery and provide an overview of the current practices for the prevention of VGD and vein graft failure. Although saphenous vein grafts (SVGs) are the most commonly used conduit in coronary artery bypass graft surgery, vein graft failure (VGF) occurs in almost half of all patients with SVGs by 10 years after surgery. In this Review, Caliskan and colleagues discuss approaches to prevent saphenous VGF, including optimal harvesting techniques and intraoperative preservation strategies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Caliskan, Etem UNSPECIFIED orcid.org/0000-0002-9051-7841 UNSPECIFIED De Souza, Domingos Ramos UNSPECIFIED UNSPECIFIED UNSPECIFIED Boening, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Pepper, John UNSPECIFIED UNSPECIFIED UNSPECIFIED Gibson, C. Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Perrault, Louis P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Randall K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kim, Ki-Bong UNSPECIFIED UNSPECIFIED UNSPECIFIED Emmert, Maximilian Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-343577
DOI:	10.1038/s41569-019-0249-3
Journal or Publication Title:	Nat. Rev. Cardiol.
Volume:	17
Number:	3
Page Range:	S. 155 - 170
Date:	2020
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	NEW YORK
ISSN:	1759-5010
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTERNAL-THORACIC-ARTERY; DIRECT MYOCARDIAL REVASCULARIZATION; ENDOTHELIAL VASCULAR FUNCTION; EVEROLIMUS-ELUTING STENTS; RADIAL-ARTERY; FOLLOW-UP; RANDOMIZED-TRIAL; LONG-TERM; CLINICAL-OUTCOMES; NITRIC-OXIDE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34357