Coronary artery bypass grafting is an effective treatment for myocardial ischaemia
and is particularly important in patients with multivessel disease and diabetes. However,
up to 40% of saphenous vein grafts will occlude within 10 years of surgery. The predominant
mechanisms for saphenous vein graft disease are thrombosis, intimal hyperplasia, and
accelerated atherosclerosis. The pathology of these changes and the role of key factors
such as nitric oxide, cellular proliferation, and the role of hypercholesterolemia
and hypertriglyceridaemia, are reviewed. Saphenous vein graft disease is among the
first cardiovascular conditions to show significant benefit from gene therapy and
promises to show remarkable developments in the near future.
KEYWORDS
Coronary artery bypass grafting - saphenous vein grafts - intimal hyperplasia - hyperlipidaemia
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32N-35N
Professor
Leonard Kritharides
Department of Cardiology, 3 West, Concord Repatriation General Hospital
Hospital Road, Concord, NSW 2139, Australia
