In patients with coronary artery disease, surgical revascu- larization with arterial or venous bypass grafts not only relieves symptoms, but also prolongs life. The result of such interventions, however, is frequently impaired by graft dysfunction and occlusion. This monograph highlights the clinical importance of coronary artery bypass graft disease and, in particular, the use of modern diagnostic techniques to assess graft structure and function. The molecular and cellular mechanisms of coronary bypass graft disease are ex- tensively discussed with several chapters devoted to prophy- lactic medical therapy. The indication, technique and results of reinterventions with balloon angioplasty, reope- ration or transplantation in patients with graft failure are also reviewed.

The Problem

The Natural History of Saphenous Vein Grafts
Risks and Prediction of Adverse after Coronary Bypass Grafting based on a Single Center Experience
Mechanisms of Plaque Formation and Occlusion in Venous Coronary Bypass Grafts
Surgical Aspects
Arterial and Venous Coronary Bypass Grafts: Surgical Techniques and Outcome
Newer Arterial Coronary Bypass Conduits: Right Gastroepiploic and Epigastric Artery
Diagnosis of Graft Failure
The Role of Radionuclide Imaging in the Diagnosis of Coronary Bypass Graft Failure
Coronary Artery Graft Disease: Diagnosis of Graft Failure by Magnetic Resonance Imaging
Positron Emission Tomography: Evaluation of Myocardial Blood Flow and Viability Before and Following Coronary Revascularization
Transcutaneous Assessment of Blood Flow in Internal Thoracic Artery to Coronary Artery Grafts
Coronary Angiography in the Diagnosis of Graft Failure
Left Ventricular Function: Systolic and Diastolic Alterations
Biological Characteristics and Coronary Bypass Grafts
Endothelium and Vascular Smooth Muscle Function of Coronary Bypass Grafts
Smooth Muscle Cell Proliferation Responses in Organ Cultures of Human Saphenous Vein
Chronic Changes in Venous Grafts After Implantation
Pharmacological Intervention
Lipids and Lipid-Lowering Drugs and Graft Function
Treatment of Severe Hypercholesterolemia in Patients with Coronary Heart Disease by Means of Lipoprotein Apheresis
Antiplatelet Drugs
Anticoagulants and Antiplatelet Drugs to Prevent Aortocoronary Vein Graft Occlusion
Calcium Antagonists in Patients Undergoing Coronary Artery Bypass Surgery
Revascularization Strategies
Percutaneous Transluminal Coronary Angioplasty in Patients with Failed Bypass Graft Surgery
Intraluminal Stents in Coronary Bypass Grafts
Reoperation: Techniques and Choice of Conduits
Cardiac Transplantation for Ischaemic Heart Disease.