A New Chest Radiography Clue to Predict Saphenous Vein Graft Failure

Objective: Saphenous vein graft failure (VGF) is a measure of the short- and long-term success of coronary artery bypass graft surgery (CABG). Aortic arch calcification (AAC) is a long-term finding of atherosclerosis in large vessels. The aim of this study was to evaluate the relationship between AAC and VGF.
Materials and Methods: Patients who underwent CABG surgery and subsequent coronary angiography in a single hospital between January 2010 and January 2021 were included in the study. The presence and stage of AAC was evaluated using preoperative chest X-rays. VGF was defined as ≥75% stenosis and/or total occlusion in the saphenous vein graft. In addition, the effect of AAC on VGF was evaluated based on the time elapsed since the CABG procedure.
Results: Of the 594 patients who underwent CABG during the study period, 91 patients (mean age 63.6±10.0; 71 [78.0%] male) were included in the study. VGF was observed in 49 (53.8%) patients. AAC was found to be an independent predictor of VGF (odds ratio [OR]: 2.788, 95% confidence interval [CI]: 1.068–7.278). The results indicated no association between AAC and VGF in patients whose coronaries were screened within 1 year (OR: 1.143, 95% CI: 0.279–4.683), while there was a strong association between AAC and VGF in patients who were screened 1 year after the surgery (OR: 5.355, 95% CI: 1.618–17.720).
Conclusion: AAC evaluation may be a valuable diagnostic method to predict VGF after CABG, and particularly late VGF.