Related Experiment Video
Updated: Jul 14, 2026
Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Does stenosis severity of native vessels influence bypass graft patency? A prospective fractional flow reserve-guided
Cornelis J Botman1, Jacques Schonberger, Sjaak Koolen
1Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. bot.joost@wxs.nl
Insights
Coronary artery bypass graft patency after one year is higher for significant lesions. However, grafting nonsignificant lesions does not lead to worse clinical outcomes like angina or repeat interventions.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Coronary artery bypass grafting (CABG) can lead to graft occlusion or narrowing over time.
- Assessing graft patency is crucial for long-term patient outcomes.
Purpose of the Study:
- To evaluate 1-year angiographic bypass graft patency.
- To determine if grafting functionally nonsignificant coronary lesions impacts early graft dysfunction.
Main Methods:
- 164 patients undergoing CABG for intermediate lesions were included.
- Fractional flow reserve (FFR) measured lesion significance; surgeons were blinded to FFR.
- Coronary angiography assessed bypass graft patency at 1 year.
Main Results:
- Graft occlusion rates were 8.9% for significant lesions vs. 21.4% for nonsignificant lesions.
- No significant differences in angina class or repeat interventions were observed between groups.
Conclusions:
- Bypass grafts on functionally significant lesions show higher patency rates.
- Grafting nonsignificant lesions did not result in adverse clinical events, suggesting limited clinical impact.
Background:
After coronary bypass surgery, occlusion or narrowing of bypass grafts may occur over time. The present study prospectively evaluated the angiographic patency of bypass grafts after 1 year in relation to the preoperative angiographic and functionally severity of the coronary lesion assessed by fractional flow reserve measurement to test the hypothesis that grafting of less critical stenosis may be a risk factor for early dysfunction of the graft.
Methods:
The study comprised 164 patients eligible for coronary artery bypass surgery who were not suitable for percutaneous intervention and with at least one intermediate lesion. Fractional flow reserve was measured in all lesions to be grafted to establish if a lesion was functionally significant. The surgeon was blinded to the results of these measurements. One year after surgery, coronary angiography was performed to establish bypass graft patency.
Results:
At coronary angiography after 1 year, 8.9% of the bypass grafts on functionally significant lesions were occluded, and 21.4% of the bypass grafts on functionally nonsignificant lesions were occluded. There was no difference in angina class or repeat interventions between patients with or without occluded bypass grafts.
Conclusions:
The patency of bypass grafts on functionally significant lesions is significantly higher than the patency of bypass grafts on nonsignificant lesions; however, this finding has no clinical relevance because patients with patent or occluded bypass grafts on nonsignificant lesions did not experience an excess of angina or repeat interventions.
