COVID-19 - Endothelial Axis and Coronary Artery Bypass Graft Patency: a Target for Therapeutic Intervention?

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Vascular Surgery

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is linked to endothelial inflammation and vascular dysfunction in COVID-19 patients.
• Coronary artery bypass grafting (CABG) frequently utilizes saphenous vein (SV) grafts, which are susceptible to endothelial dysfunction and inflammation, leading to low patency rates.

Purpose of the Study:

• To investigate the potential impact of COVID-19 on the patency of coronary artery bypass grafts, particularly SV grafts.
• To explore the mechanisms by which SARS-CoV-2 might compromise graft patency, focusing on vascular inflammation, endothelial dysfunction, and thrombosis.

Main Methods:

• Review of existing literature on SARS-CoV-2, endothelial function, and CABG graft outcomes.
• Analysis of the proposed mechanism involving SARS-CoV-2 binding to angiotensin-converting enzyme 2 receptors.
• Discussion of SV graft harvesting techniques and potential therapeutic targets.

Main Results:

• SARS-CoV-2 infection may induce vascular inflammation, endothelial dysfunction, and thrombosis in CABG vessels.
• These effects, mediated by ACE2 receptor binding, could significantly reduce the patency rates of SV grafts in COVID-19 patients.

Conclusions:

• COVID-19 poses a potential risk to the long-term patency of CABG grafts, especially SV grafts.
• Therapeutic strategies targeting endothelial dysfunction, vascular inflammation, and thrombosis are crucial for protecting coronary artery bypass grafts in COVID-19 infected CABG patients.