Lin S, Rao C, Yang L, et al. - Researchers examined how chronic total occlusion (CTO) affects long-term graft failure and outcomes in patients who underwent coronary artery bypass grafting (CABG). For conducting this observational study involving a single-center subgroup of CORONARY trial, they invited all patients alive at 6 to 9 years after CABG for coronary computed tomography angiography (cCTA) and clinical follow-up. Enrollment of a total of 349 CABG patients was done between May 2007 and October 2011. At follow-up time (Median, 6.8 years; interquartile range, 6.0-8.0 years), 301 patients were alive; of these, 206 patients (68.4%) with 723 grafts (154 CTO grafts and 569 non-CTO grafts) underwent repeat cCTA. They observed an association of CTO graft with an increased risk of graft failure. CTO graft patency was observed to be correlated with arterial graft, side-to-side anastomosis, higher graft flow and antiplatelet therapy at discharge. Enhancement in CTO graft patency should occur with surgical technique and guideline-directed medical therapy.