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Coronary bypass graft surgery accentuates proximal coronary disease progression!

• Optical coherence tomography imaging demonstrated that patients with prior coronary artery bypass graft surgery (CABG) to the left coronary circulation have greater amount of calcium in the distal left main coronary artery and proximal segments of the left anterior descending and left circumflex artery compared to those without prior CABG. • Atherosclerotic disease progression in coronary segments proximal to bypass grafts should be considered in decision-making for patients undergoing CABG. • Further studies are needed to better elucidate the mechanisms and implications of atherosclerotic disease progression in coronary segments proximal to bypass grafts.