Review ArticlesCare of the Post-CABG PatientCollins, David MD*; Goldberg, Sheldon MD, FACC†Author Information From the *Department of Medicine †Division of Cardiology, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA. Disclosure: The authors have no conflicts of interest to report. Correspondence: David Collins, MD, Department of Medicine, Pennsylvania Hospital, 800 Spruce St., Philadelphia, PA, 19107. E-mail: firstname.lastname@example.org. Cardiology in Review: January/February 2020 - Volume 28 - Issue 1 - p 26-35 doi: 10.1097/CRD.0000000000000261 Buy Metrics Abstract An estimated 400,000 coronary artery bypass graft operations are performed annually in the United States. Saphenous vein grafts are the most commonly used conduits; however, graft failure is common. In contrast, left internal mammary artery grafts have more favorable long-term patency rates. Guidelines recommend aggressive secondary prevention. In the 2 decades following surgery, 16% of patients require repeat revascularization, and percutaneous coronary intervention accounts for 98% of procedures performed. Post-coronary artery bypass graft patients presenting with symptoms of acute coronary syndrome or progressive heart failure should undergo early coronary angiography given the high likelihood that such a presentation represents graft failure. Percutaneous coronary intervention in degenerated saphenous vein grafts is associated with embolization that may cause the “no-reflow phenomenon,” which can be avoided with the use of embolic protection devices. Hybrid revascularization procedures are a promising emerging strategy to avoid the placement of vein grafts. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.