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Coronary artery bypass graft (CABG) surgery is the standard of care in the treatment of advanced coronary artery disease (CAD). In order to bypass coronary occlusions, CABG surgery traditionally employs grafts from the left internal thoracic/mammary artery (LITA/IMA), radial artery (RA), and greater saphenous vein (SV). The risk of CABG failure is reported to be higher, or at best similar, for women than for men, and it relates primarily to post-operative accelerated atherosclerosis leading to graft stenosis and recurrent angina, a phenomenon known as "coronary artery bypass graft disease". In this paper, the authors hypothesize that employing an alternative arterial conduit may help reduce the rate of post-CABG accelerated atherosclerosis in women, and propose that a uterine artery specimen be used instead. Given its greater density of estrogen-receptor alpha (ER-α) relative to other mammalian endothelial cells in the vasculature, uterine arteries may exhibit important anti-atherosclerotic properties. Theoretically, this effect may be amplified with the adjuvant administration of low-dose selective ER-α agonist modulator (SERM) therapy. Copyright © 2012 Elsevier Ltd. All rights reserved.


Jacques Balayla, Marcel Edwards, Ariel Lefkowitz. Uterine artery as an arterial conduit for coronary artery bypass graft (CABG) surgery in women: A role for estrogen-receptor alpha (ER-α) in the prevention of post-CABG accelerated atherosclerosis and graft disease. Medical hypotheses. 2013 Feb;80(2):162-6

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PMID: 23219505

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