Clinical aspects of graft failure

Abstract

The patient with graft restenosis presents a variable clinical picture with multiple aspects. This may be explained by a series of factors, such as the initial aspect of the revascularized coronary lesions, graft type and number, restenosis coexistence, graft permeability, incomplete revascularization, pre-graft cardiac performance, postsurgical complications, new distal graft coronary lesions etc. Recurrence of different Canadian Cardiovascular Society (CCS) class angina is the most important clinical sign that draws the clinician’s attention and makes him suspect graft dysfunction. Angina-free patients may require repeated catheterization when presenting with cardiac insuffi ciency, arrhythmias, or electrocardiographic alterations. Graft dysfunction can also be asymptomatic due to collateral circulation development as a consequence of slowly progressing in-graft lesion.