{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:53:06Z","timestamp":1791355986682,"version":"4.3.1"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"\n Background<\/jats:title>\n The impact of the left internal mammary artery (LIMA)\u2013to\u2013left anterior descending artery (LAD) anastomotic location on graft patency remains uncertain.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study included 1597 patients with isolated proximal LAD lesions from the PATENCY\u00a0(Graft Patency Between no\u2010touch Vein Harvesting Technique and Conventional Approach in Coronary Artery Bypass Graft Surgery) trial who underwent coronary artery bypass grafting. The relative anastomotic site (RAS) of the LIMA\u2013LAD anastomosis was quantified using postoperative coronary computed tomography angiography and defined as the ratio of anastomotic height\/heart height. The primary end point was LIMA occlusion at 3\u2009years, and the secondary end point was major adverse cardiac events. Multivariable logistic regression was used to evaluate the association between RAS and 3\u2010year LIMA occlusion, and Cox proportional hazards regression was used to evaluate associations with time\u2010to\u2010event clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The exploratory RAS threshold was 46%. Distal anastomosis (RAS >46%) was associated with a significantly lower 3\u2010year LIMA occlusion rate compared with proximal anastomosis (RAS \u226446%) (2.3% versus 6.3%; adjusted odds ratio, 0.37 [95% CI, 0.20\u20130.68];\n P<\/jats:italic>\n =0.002). At 3\u2009years, major adverse cardiac event rates were similar between groups (3.4% versus 4.4%; adjusted hazard ratio, 0.68 [95% CI, 0.40\u20131.15];\n P<\/jats:italic>\n =0.16).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In patients with isolated proximal LAD disease, a more distal LIMA\u2013LAD anastomotic location may be associated with a lower risk of graft occlusion at 3\u2009years. Further prospective validation is warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.126.051333","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:34:35Z","timestamp":1789738475000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Left Internal Mammary Artery\u2013to\u2013Left Anterior Descending Artery Anastomotic Location on Graft Patency: A\u00a0Secondary Analysis of the PATENCY Trial Data Set"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8862-3266","authenticated-orcid":false,"given":"Chunyuan","family":"Wang","sequence":"first","affiliation":[{"name":"Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meice","family":"Tian","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Hou","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Feng","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3629-2231","authenticated-orcid":false,"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5736-3793","authenticated-orcid":false,"given":"Zhan","family":"Hu","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, 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