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To the Editor:Zacharias and colleagues1 report improved survival with radial artery conduits versus vein graft in coronary artery bypass graft (CABG) surgery with left internal mammary artery to left anterior descending artery, as well as better radial patency. This study reinforces previous findings demonstrating superior patency of arterial conduits over vein grafts. Nonetheless, graft patency and improved survival outcomes extend beyond the boundaries of the operating room.The pathogenesis of saphenous vein graft closure includes acute thrombosis, subacute intimal hyperplasia, and chronic graft atherosclerosis.2 However, arterial grafts, thought to be more resistant to atherosclerosis, have exhibited early atherosclerotic signs in radial artery grafts (RAGs) without apparent …

Factors Affecting Graft Patency: The Operating Room and Beyond