Evaluation of the relationship between short to medium-term patency of saphenous grafts used in coronary artery bypass grafting operations and shear wave elastography of the great saphenous vein

Background: Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease (CAD), with saphenous vein grafts (SVG) frequently used for revascularization. However, SVGs have limited long-term patency due to factors such as atherosclerosis and fibroplasia. Sonoelastography offers a non-invasive method to assess tissue elasticity, potentially aiding in predicting graft patency post-CABG. Methods: In this prospective study, 77 coronary bypass grafts used in 22 patients who underwent elective coronary artery bypass grafting surgery were examined. The stiffness of the great saphenous veins of the patients was measured in kilopascals using shear wave elastography (SWE) preoperatively. The patency of the grafts was assessed 12 to 24 months postoperatively using coronary computed tomography angiography. Statistical analyses included the Mann-Whitney U test, Chi-square test, Fisher's exact Chi-square test, multifactorial and curve fit regression analysis.. Results: The study found a significant relationship between preoperative venous stiffness and graft occlusion. Patients with higher venous stiffness measured by SWE showed a higher incidence of graft occlusion. Multivariate regression analysis confirmed that venous stiffness is an independent predictor of graft patency (p=0.042). Conclusion: Grafts with higher sonoelastogram values of the great saphenous vein were found to have higher rates of occlusion. This finding suggests that sonoelastography can play a critical role in predicting graft patency and thereby improving the success of coronary bypass surgery. These findings have the potential to enhance graft selection strategies and improve patient outcomes in CABG procedures.