Original Scientific Articles

Early and long-term outcomes after coronary artery bypass grafting using saphenous vein grafts

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Abstract

Introduction: Coronary Artery Bypass Grafting (CABG) remains the cornerstone of surgical myocardial revascularization. Despite major technical refinements and the increasing use of arterial conduits, saphenous vein grafts (SVGs) continue to play a vital role but remain vulnerable to long-term occlusion. The aim of the study was to evaluate early and long-term outcomes after CABG using vein grafts and to identify independent predictors of graft patency.

Methods: A retrospective analysis of the ICVDV CABG Registry (20102022) included 163 patients who underwent re-coronarography ? 5 years after surgery. Graft patency (patent, stenotic, or occluded) was correlated with clinical and anatomical variables using univariate and multivariable logistic regression (p < 0.05).

Results: Among all grafts, 51.5% were patent, 37.4% occluded, and 11.0% stenotic. Patency correlated significantly with larger distal anastomosis diameter (p = 0.045) and lower triglyceride levels (p = 0.017). Both remained independent predictors in multivariable analysis: distal anastomosis diameter (OR = 1.3; 95% CI 1.08-1.56; p = 0.005) and triglycerides (OR = 2.2; 95% CI 1.65-2.93; p < 0.001).

Conclusion: Distal-anastomosis geometry and triglyceride control are critical determinants of long-term vein-graft patency. Combining meticulous operative technique with sustained lipid optimization provides the most effective strategy for improving graft longevity and patient outcomes.

Keywords: CABG, saphenous vein graft, graft patency, triglycerides, anastomosis, coronary revascularization

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