The association between coronary graft patency and clinical status in patients with coronary artery disease

Eur Heart J. 2021 Apr 7;42(14):1433-1441. doi: 10.1093/eurheartj/ehab096.


The concept of a direct association between coronary graft patency and clinical status is generally accepted. However, the relationship is more complex and variable than usually thought. Key issues are the lack of a common definition of graft occlusion and of a standardized imaging protocol for patients undergoing coronary bypass surgery. Factors like the type of graft, the timing of the occlusion, and the amount of myocardium at risk, as well as baseline patients' characteristics, modulate the patency-to-clinical status association. Available evidence suggests that graft occlusion is more often associated with non-fatal events rather than death. Also, graft failure due to competitive flow is generally a benign event, while graft occlusion in a graft-dependent circulation is associated with clinical symptoms. In this systematic review, we summarize the evidence on the association between graft status and clinical outcomes.

Keywords: CABG; Graft failure; Patency.

Publication types

  • Systematic Review

MeSH terms

  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Artery Disease* / surgery
  • Coronary Vessels
  • Graft Occlusion, Vascular
  • Humans
  • Treatment Outcome
  • Vascular Patency