Does grafting of left anterior descending artery with right internal mammary artery have an impact on late outcomes in the context of multiple arterial grafting?

Background Universally, anastomosis of the left internal mammary artery (LIMA) to the left anterior descending artery (LAD) is accepted as the gold standard in coronary artery bypass grafting. The use of the right internal mammary artery (RIMA) for grafting the LAD has recently emerged as an alternative to avoid composite configuration in multiple arterial grafting using bilateral internal mammary arteries. Whether this recently emerged alternative strategy of RIMA to LAD is as effective as the well-established gold standard LIMA to LAD remains unknown. We investigated the impact of using RIMA for grafting of LAD on late outcomes in the context of multiple arterial grafting.