REVIEW article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Determinants of Graft Patency After Coronary Artery Bypass Grafting
Binzhou Medical University Hospital, Binzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Coronary artery bypass grafting (CABG) remains central for multivessel coronary artery disease, but durable benefit depends on graft patency. Patency reflects interacting anatomical, technical, haemodynamic, biological and patient-level determinants. The endothelium offers a useful the metabolically active interface because it regulates vascular tone, thrombosis, inflammation, leukocyte trafficking and repair. This Review examines how conduit choice, harvesting, preservation, anastomotic geometry, target anatomy, operative strategy and comorbidity drive early thrombosis, intermediate intimal hyperplasia and late atherosclerosis. Particular emphasis is placed on oxidative stress, endothelial nitric oxide synthase dysfunction, reduced endothelial nitric oxide (eNO) bioavailability and pathological reactive oxygen species (ROS) signalling. Accordingly, We focus on endothelial nitric oxide synthase (eNOS) dysfunction, reduced eNO bioavailability and pathological ROS signalling, and present an eNOS/ROS-centred research framework requiring local delivery, temporal control and CABG-specific validation.
Summary
Keywords
coronary artery bypass grafting, endothelial dysfunction, Graft patency, Nitric Oxide, Oxidative Stress, Reactive Oxygen Species, Saphenous vein graft
Received
08 May 2026
Accepted
14 July 2026
Copyright
© 2026 Ti, Dong and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Sheng-Jun Dong; Yu-ting Wu
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.