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Updated: Nov 25, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Nonautologous Grafts in Coronary Artery Bypass Surgery: A Systematic Review
Savvas Lampridis1, Sarah J George1
1Bristol Medical School, University of Bristol, Bristol, United Kingdom.
Insights
Nonautologous grafts for coronary artery bypass grafting show variable patency. Autologous endothelial cell-seeded synthetic grafts show promise but need more research for optimal outcomes.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
Background:
- Coronary artery bypass grafting (CABG) often requires autologous conduits.
- Graft availability can be a limiting factor in CABG procedures.
Purpose of the Study:
- To review the current status and patency rates of nonautologous grafts used in CABG.
- To evaluate alternative conduits when autologous options are insufficient.
Main Methods:
- A comprehensive literature search was conducted on MEDLINE, Embase Classic, and Embase.
- The search covered publications from 1960 to April 2020.
- Twenty-one studies detailing graft patency were included in the review.
Main Results:
- Patency rates varied significantly across different nonautologous graft types.
- Homologous saphenous veins showed patency from 0% to 66.7%.
- Expanded polytetrafluoroethylene (ePTFE) grafts ranged from 14.3% to 80% patency.
- Autologous endothelial cell-seeded ePTFE grafts demonstrated higher patency (up to 94.7%) compared to other nonautologous options.
Conclusions:
- Achieving a nonautologous conduit with patency comparable to autografts remains a challenge.
- Autologous endothelial cell-seeded synthetic grafts show potential but require further investigation.
- The search for ideal alternative conduits for CABG continues.
Background:
Suitable autologous conduits may be lacking when performing coronary artery bypass grafting. The aim of this review is to determine the status of nonautologous grafts in coronary artery bypass grafting.
Methods:
We conducted a literature search on MEDLINE All, Embase Classic, and Embase through Ovid from 1960 to April 2020.
Results:
Of the 1579 records identified, 21 studies were included in the review. The following grafts were assessed for patency: 109 homologous saphenous veins (patency rates ranged from 66.7% at a median follow-up of 8.5 months to 0% at 6-12 months and 7-18 months, respectively), 29 expanded polytetrafluoroethylene grafts (from 80% at a median follow-up of 5 months to 14.3% at 45 months), 12 human umbilical veins (50% at a median follow-up of 6 months), 50 Bioflow bovine internal mammary arteries (from 15.8% to 0% at a mean follow-up of 9.5 months and 19 months, respectively), 39 Perma-Flow grafts (80% and 76.9% at 1-3 months and 12 months, respectively), 20 No-React bovine internal mammary arteries (57.1% at a median follow-up of 28 months and 23.1% at a mean follow-up of 7 months), 40 autologous venous endothelial cell-seeded expanded polytetrafluoroethylene grafts (94.7% and 81% at a mean follow-up of 27 months and 60 months, respectively), and 12 autologous venous endothelial cell-seeded cryopreserved homologous veins (83.3% at a mean follow-up of 8.5 months).
Conclusions:
The goal of an alternative conduit with patency and attributes that match those of autografts remains elusive. Autologous endothelial cell-seeded synthetic grafts have demonstrated promising results but require further investigation.
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