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Institute for Cardiovascular Diseases of Vojvodina , Kamenica , Serbia
Institute for Cardiovascular Diseases of Vojvodina , Kamenica , Serbia
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.
Conceptualization, A.B.; Data curation, A.B.; Formal Analysis, A.B. and A.R.; Investigation, A.B.; Methodology, A.B.; Resources, A.B.; Writing – original draft, A.B.; Validation, A.R. All authors have read and agreed to the published version of the manuscript.
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