COVID-19 — Endothelial Axis and Coronary Artery Bypass Graft Patency: a Target for Therapeutic Intervention?

Abstract

It has been reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection induces endothelial inflammation, therefore facilitating the progression of endothelial and vascular dysfunction in coronavirus disease 2019 (COVID-19) patients. Coronary artery bypass grafting (CABG) involves mainly the use of the saphenous vein (SV) and internal mammary artery as graft material in the stenosed coronary arteries. Unfortunately, graft patency of the SV is low due to endothelial dysfunction and inflammation. We propose that SARS-CoV-2 might cause vascular inflammation, endothelial dysfunction, and thrombosis in coronary artery bypass graft vessels by binding angiotensin-converting enzyme 2 receptor. Therefore, in this Special Article, we consider the potential influence of COVID-19 on the patency rates of coronary artery bypass graft vessels, mainly with reference to the SV. Moreover, we discuss the technique of SV graft harvesting and the therapeutic potential of focusing on endothelial dysfunction, vascular inflammation, and thrombosis for protecting coronary artery bypass grafts in COVID-19 infected CABG patients.

Contribution of Radiologist in the Management of Pseudo-aneurysm and Neck Hemorrhages in COVID-19 patients.

“…SARS-CoV-2 is known to be associated with endothelial inflammation that weakens the vascular wall. 1 In our first reported case, it seems conceivable that the tracheotomy tube could have weaken the cricoarytenoid artery through a friction mechanism. This kind of post-tracheotomy complication was however poorly reported in the literature, 3 strengthening the need to monitor patients with severe COVID-19 after the realization of surgical tracheotomy.…”

“…It has been reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be associated with endothelial inflammation and an increasing risk of hemorrhage. 1 Because the infection is associated with a high risk of aerosolization and related healthcare provider contamination, the treatment of vascular lesions has to be as conservative as possible. 2 From March, 1 st 2020 to May 28 th 2020, 74 patients with severe coronavirus disease 2019 (COVID-19) were hospitalized in our intensive care unit (ICU) and 35 patients benefiting from surgical tracheotomy (47%).…”

Contribution of Interventional Radiologist in the Management of Pseudoaneurysm and Neck Hemorrhages in COVID-19 patients

“…Severe acute respiratory syndrome coronavirus 2 is known to be associated with endothelial inflammation and vascular wall impairment. 1 In the first case, it seems conceivable that the tracheotomy tube had weaken the cricoarytenoid artery through a friction mechanism. This kind of complication was poorly reported in the literature, 3 which strengthens the need to monitor patients with severe COVID-19 and tracheotomy.…”

“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be associated with endothelial inflammation and an increasing risk of hemorrhage. 1 Because the infection is associated with a high risk of aerosolization and related health care provider contamination, the treatment of vascular lesions has to be as conservative as possible. 2 From March 1, 2020, to May 28, 2020, 74 patients with severe coronavirus disease 2019 (COVID-19) were hospitalized in our intensive care unit (ICU) and 35 (47%) patients benefited from surgical tracheotomy.…”

Cardiovascular Disease Complicating COVID-19 in the Elderly

“…Coronary microvascular endothelial inflammation could lead to myocardial injury [ 125 ]. The potential for COVID-19 to compromise the patency of coronary bypass grafts has been suggested [ 167 ].…”