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Chronic total occlusions (CTO) are found commonly in patients with prior coronary artery bypass grafting (CABG). We sought to determine the effect of CABG on collateral robustness in patients with a CTO. Patients with a CTO diagnosed on coronary angiography between July 2010 and December 2019 were included in this study. Patients were classified as either CTO supplied by a functional graft, CTO supplied by collaterals from a non-grafted donor vessel (non-grafted) or a CTO supplied by collaterals from a grafted donor vessel (grafted). The degree of collateral robustness was determined by the Rentrop classification and collateral connection (CC) grade. Demographic, angiographic and clinical outcomes were recorded. A total of 2088 CTO lesions were identified, of which 878 (42.0%) were supplied by a functional graft, 994 (47.6%) CTOs were supplied by a non-grafted donor vessel and 216 (10.3%) CTOs were supplied by a grafted donor vessel. CTOs supplied by a grafted donor vessel had lower rates of robust collaterals (37.0% vs 83.0%, p < 0.0001) with less mature collaterals as determined by the Rentrop grade (p < 0.0001) and CC grade (p < 0.0001) as compared to CTOs supplied by a non-grafted donor vessel. In patients with a previous CABG, a grafted donor vessel results in less robust coronary collaterals with lower Rentrop and CC grade compared to an ungrafted donor vessel. This may be attributable to changes in coronary blood flow and shear stress, and may be a factor in the lower procedural success rates for CTO intervention in patients with prior CABG.

Titel:	Impact of coronary artery bypass grafting (CABG) on coronary collaterals in patients with a chronic total occlusion (CTO).
Autor/in / Beteiligte Person:	Allahwala, UK ; Ekmejian, A ; Mughal, N ; Brieger, D ; Nour, D ; Ciofani, JL ; Weaver, JC ; Ward, M ; Bhindi, R
Link:	View record at Springer (Volltext)
Zeitschrift:	The international journal of cardiovascular imaging, Jg. 37 (2021-12-01), Heft 12, S. 3373-3380
Veröffentlichung:	[New York] : Springer ; <i>Original Publication</i>: Boston : Kluwer Academic Publishers, c2001-, 2021
Medientyp:	academicJournal
ISSN:	1875-8312 (electronic)
DOI:	10.1007/s10554-021-02327-8
Schlagwort:	Chronic Disease Coronary Angiography Coronary Artery Bypass adverse effects Humans Predictive Value of Tests Retrospective Studies Time Factors Treatment Outcome Coronary Occlusion diagnostic imaging Coronary Occlusion surgery Percutaneous Coronary Intervention adverse effects
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Int J Cardiovasc Imaging] 2021 Dec; Vol. 37 (12), pp. 3373-3380. <i>Date of Electronic Publication: </i>2021 Aug 28. MeSH Terms: Coronary Occlusion* / diagnostic imaging ; Coronary Occlusion* / surgery ; Percutaneous Coronary Intervention* / adverse effects ; Chronic Disease ; Coronary Angiography ; Coronary Artery Bypass / adverse effects ; Humans ; Predictive Value of Tests ; Retrospective Studies ; Time Factors ; Treatment Outcome References: Allahwala UK, Brilakis ES, Byrne J, Davies JE, Ward MR, Weaver JC, Bhindi R (2019) Applicability and interpretation of coronary physiology in the setting of a chronic total occlusion. Circ Cardiovasc Interv 12:e007813. https://doi.org/10.1161/CIRCINTERVENTIONS.119.007813. 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(PMID: 10.1161/CIRCINTERVENTIONS.120.00941232972204) Contributed Indexing: Keywords: CTO; Chronic total occlusion; Coronary artery bypass grafting; Coronary collaterals; Percutaneous coronary intervention Entry Date(s): Date Created: 20210828 Date Completed: 20211123 Latest Revision: 20211123 Update Code: 20231215

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Impact of coronary artery bypass grafting (CABG) on coronary collaterals in patients with a chronic total occlusion (CTO).