Prior CABG Patients Evaluated for Saphenous VeIn grAft DysfUnction and Progression of Coronary arTery Disease

Despite advances in secondary prevention, a wide variety of vascular grafts available, and evolving surgical techniques, long-term efficacy of CABG is hampered by bypass graft failure and native CAD progression. Therefore, patients with prior CABG often present with recurrent ischemic symptoms. Indeed, many prior CABG patients undergo repeat cardiac catheterization and require subsequent revascularization therapy. The clinical evaluation and diagnostic work-up of patients with recurrent angina after CABG is challenging. Patients with previous CABG are generally older, have a higher prevalence of cardiac risk factors and comorbidities, more extensive CAD, and complex atherosclerotic lesion morphology. Furthermore, current guideline recommendations on patient management are limited since post-CABG patients have often been underrepresented or excluded in large diagnostic and revascularization trials. This registry will include patients presenting with recurrent ischemic symptoms with a history of CABG and ≥1 SVGs that are referred to the Amsterdam University Medical Centers. Patients will be eligible for inclusion in the VIADUCT registry after consideration of in- and exclusion criteria. Subsequently, patients will be approached for study participation. Patients are free to refuse or to withdraw from participation in the registry at any moment. The primary objective is to investigate clinical outcomes in patients with recurrent symptoms who are evaluated for bypass graft failure and native CAD progression. In addition, results from non-invasive and invasive diagnostic tools that are used during clinical work-up to assess graft patency, the hemodynamic significance of native CAD progression, left ventricular function, and myocardial viability will be collected. We aim to evaluate the value of such tools to guide optimal repeat revascularization strategy.

• Major Adverse Cardiac Events [Срок оценки: 3 and 5 years follow-up]
• Procedural success and mortality in patients who underwent percutaneous coronary intervention of a saphenous vein graft [Срок оценки: In hospital and during subsequent 3 and 5 years follow-up]
• Procedural success and mortality in patients who underwent percutaneous coronary intervention of a (bypassed) native coronary artery [Срок оценки: In hospital and during subsequent 3 and 5 years follow-up]
• Quality of life assessed by the Canadian Cardiovascular Society (CCS) Grading Scale [Срок оценки: At baseline and during subsequent 3 and 5 years follow-up]
• Quality of life assessed by Rose dyspnea scale questionnaire (RDS) [Срок оценки: At baseline and during subsequent 3 and 5 years follow-up]
• Composite score of quality of life [Срок оценки: At baseline and during subsequent 3 and 5 years follow-up]