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Saphenous vein graft and nitric oxide: strategies to prevent graft failure and enhance patency in coronary artery bypass grafting

Title: Saphenous vein graft and nitric oxide: strategies to prevent graft failure and enhance patency in coronary artery bypass grafting
Authors: Dell’Aquila, Michele; Prapas, Sotirios; Falco, Giorgia; Abdalla, Shadi; Tejada, Branden; Challagalla, Meher; Condello, Ignazio; Newman, Joshua; Jarral, Omar; Pupovac, Stevan; Ali, Ameerah; Katsavrias, Konstantinos; D’Onofrio, Augusto; Zebele, Carlo; Totaro, Antonio; Labriola, Vincenzo; Caldonazo, Tulio; Kirov, Hristo; Di Franco, Antonino; Leith, Jordan; Rong, Lisa; Rahouma, Mohammed; Brinster, Derek; Iribarne, Alexander; Manetta, Frank; Patel, Nirav; Kalimi, Robert; Gaudino, Mario; Calafiore, Antonio Maria
Publication Year: 2026
Collection: Digital Library Thüringen
Subject Terms: article; ScholarlyArticle; ddc:610; bibliography; composite graft; coronary artery bypass graft (CABG); endothelial dysfunction; graft failure; graft patency; nitric oxide (NO); perivascular adipose tissue (PVAT); saphenous vein graft (SVG)
Description: Nitric oxide (NO) is a central regulator of vascular homeostasis and a key determinant of saphenous vein graft (SVG) outcomes in coronary artery bypass grafting (CABG). Endothelial dysfunction, driven by altered shear stress, oxidative stress, and cardiovascular risk factors, impairs NO production and release, contributing to SVG thrombosis, intimal hyperplasia, and atherosclerosis. SVG harvesting technique, storage, and intraoperative handling affects endothelial integrity, inflammatory response, and vascular remodeling, influencing arterialization, long-term patency, and clinical outcomes. Preservation of perivascular adipose tissue (PVAT) during vein harvesting enhances NO bioavailability, reduces inflammation and oxidative stress, and supports graft adaptation. Internal thoracic artery (ITA) grafts provide durable patency, survival benefit, and NO-mediated vasoprotection, improving SVG function and mitigating maladaptive remodeling. Graft configuration further determines SVG adaptation. ITA-composite SVGs confer continuous NO exposure, promote arterial-like remodeling, and attenuate low shear stress. Optimal secondary prevention, including antiplatelet therapy, statins and lifestyle modifications further preserves endothelial function and reduces SVG failure. Targeting NO through surgical technique, graft configuration, and pharmacologic intervention represents a unifying strategy to enhance SVG performance, arterialization, and long-term outcomes, addressing the current limitation of SVG in CABG.
Document Type: article in journal/newspaper
File Description: 21 Seiten
Language: English
Relation: Frontiers in Cardiovascular Medicine -- Front. Cardiovasc. Med. -- 2297-055X; https://doi.org/10.3389/fcvm.2025.1745260
DOI: 10.3389/fcvm.2025.1745260
Availability: https://doi.org/10.3389/fcvm.2025.1745260; https://nbn-resolving.org/urn:nbn:de:gbv:27-dbt-69337-0; https://www.db-thueringen.de/receive/dbt_mods_00069337; https://www.db-thueringen.de/servlets/MCRZipServlet/dbt_derivate_00070689
Rights: https://creativecommons.org/licenses/by/4.0/ ; public ; info:eu-repo/semantics/openAccess
Accession Number: edsbas.F1455634
Database: BASE