CORONARY ANGIOGRAPHY INTERPRETATION IN CORONARY ARTERY BYPASS GRAFTING CANDIDATES

Abstract

Coronary artery bypass grafting (CABG) remains a cornerstone revascularization strategy for patients with complex coronary artery disease (CAD) (Neumann et al., 2019). Accurate interpretation of coronary angiography is fundamental in identifying candidates who will derive the greatest clinical benefit from surgical revascularization. This chapter provides a structured framework for evaluating coronary angiographic findings in the context of CABG candidacy. Key anatomical considerations include the assessment of left main coronary artery stenosis, triple-vessel disease, proximal left anterior descending (LAD) involvement, and the presence of chronic total occlusions (Lawton et al., 2022). The role of lesion morphology, collateral circulation, and myocardial viability in surgical decision-making is examined in detail. Quantitative and qualitative angiographic parameters, including percent diameter stenosis, TIMI flow grade, and the SYNTAX score, are discussed as tools to guide and refine patient selection (Serruys et al., 2009). The integration of angiographic data with clinical variables such as left ventricular function, diabetes mellitus, and comorbidities is addressed in alignment with current guideline recommendations (Farkouh et al., 2012; Velazquez et al., 2016). Emphasis is placed on multidisciplinary Heart Team evaluation and the complementary role of non-invasive imaging (Lawton et al., 2022). Understanding these principles enables clinicians to optimize revascularization decisions and improve long-term outcomes for patients undergoing CABG.