Nitric oxide and the CABG patient

The post surgery success of coronary artery bypass grafting (CABG) is counteracted by thrombosis and de-endothelialization, intimal hyperplasia and, over the long term, atherosclerosis. There are many reasons to assume that in CABG patients vascular bioavailability of NO generated by the endothelium plays an important role for graft function. This holds true for factors such as graft type, harvesting and storage, the type of surgery, non-pharmacologic prevention of risk factors, for example, regular physical activity (if feasible), and drug therapy. Although the precise role of graft endothelial NO bioavailability for graft patency and clinical endpoints is still uncertain, current data rather speak in favor of NO indicating that the potential of vasoprotective activities of NO in the CABG patient deserves further investigation.

► First demonstration of an acetylcholine-induced endothelium dependent vasorelaxation. ► A superior patency rate of radial artery over saphenous vein grafts after 1-year. ► 'No-touch' graft harvesting is associated with less angina after 8.5 years. ► Off-pump coronary artery bypass surgery does not improve hard clinical endpoints. ► Demonstration of a lack of exercise-induced upregulation of eNOS in venous tissue.