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Updated: Aug 13, 2026
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
19-year patency of a coronary-coronary venous bypass graft
Giovanni Mariscalco1, Claudio Blanzola, Cristian Leva
1Department of Surgical Sciences, Cardiac Surgery Division, Varese University Hospital, Viale Borri 57, 21100 Varese, Italy. giovannimariscalco@yahoo.com
Insights
Long-term outcomes of coronary-coronary venous bypass grafting are unknown. A case study shows successful stenting of a 19-year-old graft, highlighting its potential for durable coronary blood flow restoration.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Long-term outcomes of coronary-coronary venous bypass grafting (CCVG) are not well-documented.
- CCVG is an alternative to aortocoronary bypass, particularly when aortic manipulation is challenging due to severe calcification.
Observation:
- A case of successful stenting of a critical stenosis in a 19-year-old CCVG is presented.
- The CCVG was initially placed to avoid manipulating a severely calcified ascending aorta.
Findings:
- Coronary-coronary bypass grafting can provide durable coronary blood flow restoration.
- Stenting is a viable option for managing stenosis in established CCVG.
- CCVG offers comparable flow rates to aortocoronary bypass.
Implications:
- Coronary-coronary bypass grafting should be considered in specific patient profiles, including severe aortic calcification, inadequate in situ graft length, or subclavian artery disease.
- This technique represents a valuable second-choice option for long-term coronary revascularization in selected individuals.
Abstract:
No data are available on the long-term outcome of coronary-coronary venous bypass grafting. We describe a case in which we successfully stented a discrete, critical stenosis of a coronary-coronary venous graft that had been placed 19 years earlier to minimize manipulation of a severely calcified ascending aorta. Coronary-coronary bypass grafting should be considered in cases involving severe aortic calcification, in situ grafts of inadequate length, and stenosed or occluded subclavian arteries. Such a bypass can be performed with either saphenous vein or arterial conduits, and it provides a flow rate similar to that of aortocoronary bypass. This option could be borne in mind as a 2nd-choice technique for the durable restoration of coronary blood flow in selected cases.
