BACKGROUND Graft occlusion after coronary artery bypass grafting (CABG) has been associated with competitive flow of native coronary arteries. OBJECTIVES To assess with coronary computed tomography angiography (CCTA) graft occlusion and coronary artery disease (CAD) progression of native vessels after CABG and their relationship with angiography-derived vessel fractional flow reserve (vFFR) performed before surgery. METHODS Between 2006 and 2018, serial vFFR analyses were obtained before CABG in each major native coronary vessel from two institutions. All patients underwent follow-up CCTA. RESULTS In 171 consecutive patients, serial preoperative angiograms were suitable for vFFR analysis of 298 grafted and 59 nongrafted vessels. Median time between CABG and CCTA was 2.1 years. Preoperative vFFR was assessed in 131 left anterior descending artery (LAD), 132 left circumflex artery (LCX) and 94 right coronary aretry (RCA) and was less than 0.80 in 255 of 298 bypassed vessels. Graft occlusion was observed at CCTA in 28 of 298 grafts. The median preoperative vFFR value of native coronaries was higher in occluded compared with patent grafts (0.75 vs. 0.60, P < 0.001) and was associated with graft. The best vFFR cut-off to predict graft occlusion was 0.67. Progression of CAD was higher in grafted than in nongrafted vessels (89.6 vs. 47.5%, P < 0.001). Pre-CABG vFFR predicted disease progression of grafted native vessels (AUC = 0.83). CONCLUSION Preoperative vFFR derived from invasive coronary angiography was able to predict graft occlusion and CAD progression of grafted coronary arteries.

中文翻译：

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术前血管造影得出的血流储备分数可以预测冠状动脉旁路移植术闭塞和疾病进展。

背景冠状动脉旁路移植术（CABG）后的移植物闭塞与自体冠状动脉的竞争性血流有关。目的 通过冠状动脉计算机断层扫描血管造影 (CCTA) 评估 CABG 后自体血管的移植物闭塞和冠状动脉疾病 (CAD) 进展，以及它们与术前进行的血管造影衍生的血管血流储备分数 (vFFR) 的关系。方法 2006 年至 2018 年间，在 CABG 之前对两个机构的每个主要天然冠状血管进行了连续 vFFR 分析。所有患者均接受 CCTA 随访。结果 在 171 名连续患者中，连续术前血管造影适合对 298 根移植血管和 59 根非移植血管进行 vFFR 分析。CABG 和 CCTA 之间的中位时间为 2.1 年。术前对 131 条左前降支 (LAD)、132 条左旋支动脉 (LCX) 和 94 条右冠状动脉 (RCA) 的 vFFR 进行了评估，298 条搭桥血管中的 255 条 vFFR 低于 0.80。在 CCTA 中观察到 298 个移植物中有 28 个发生移植物闭塞。与未闭塞的移植冠状动脉相比，术前自然冠状动脉的中位 vFFR 值较高（0.75 vs. 0.60，P < 0.001），并且与移植物相关。预测移植物闭塞的最佳 vFFR 截止值为 0.67。移植血管的 CAD 进展速度高于非移植血管（89.6% vs. 47.5%，P < 0.001）。CABG 前 vFFR 预测移植原生血管的疾病进展 (AUC = 0.83)。结论 术前源自侵入性冠状动脉造影的 vFFR 能够预测移植冠状动脉的移植物闭塞和 CAD 进展。