CABG Graft Patency — EECC MCQ

Instant feedback + full explanation. One question, done properly.

EasyCoronary Artery DiseaseCABG Graft PatencyEECC

A 70-year-old man undergoes CABG. The surgeon uses the left internal mammary artery (LIMA) to LAD and saphenous vein grafts (SVG) to the OM1 and RCA. At 10 years post-CABG, what are the expected patency rates for the LIMA and SVG grafts respectively?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — LIMA >90%; SVG approximately 50-60%

The LIMA-LAD graft has exceptional long-term patency (>90% at 10-15 years) due to the arterial wall's resistance to atherosclerosis and its endothelial function producing nitric oxide. In contrast, SVGs undergo progressive neointimal hyperplasia and atherosclerosis, with patency rates of approximately 50-60% at 10 years. This difference underpins the Class I recommendation for LIMA-LAD grafting in all CABG procedures. Bilateral internal mammary arteries (BIMA) or radial artery grafts may further improve long-term outcomes. The 2024 ESC CCS Guidelines recommend arterial conduits to maximise graft longevity.

Reference: ESC (2024): Guidelines for the Management of Chronic Coronary Syndromes