Arterial grafts in coronary bypass surgery

Abstract

During the last three decades, coronary artery bypass grafting (CABG) emerged, was developed and has progressed. The search for suitable conduits has been investigated aggressively and several venous, arterial and artificial grafts have been utilized clinically. It is clear now that the saphenous vein graft deteriorates with time and the occlusion rate reaches up to 50% at 10 years after CABG mainly due to atherosclerosis in the graft called "vein graft disease." The internal thoracic artery (ITA) graft, on the contrary, has very good long-term patency and this evidence directly relates to the superior outcome in terms of longevity and postoperative cardiac events in the long run. Based on this evidence, the use of arterial conduits for myocardial revascularization has been extended. Several autologous arteries have been investigated and utilized clinically such as the right gastroepiploic artery, the inferior epigastric artery, and the radial artery. With proper use of these new arterial conduits in addition to ITA, higher quality CABG can be performed safely, and a better long-term result can be expected.