Arterial Grafts in Coronary Artery Bypass Surgery

Coronary artery bypass grafting (CABG) is the optimal surgical treatment for multi-vessel coronary artery disease. CABG operation has successful shortand intermediate-term results, but the long-term results are variable. The variability of results in long-term particularly depends on the nature of the vascular grafts used. Angiographic studies in long-term have showed that patency rates of arterial grafts were superior to patency rates of vein grafts. Numerous studies documented an incremental survival and events free benefit by utilizing increased number of arterial grafts during CABG. Long survival has improved by total arterial revascularization compared to using left internal thoracic artery (LITA) and saphenous vein grafts (85% to 90% at 10 years versus 75% to 80%, respectively). Total arterial revascularization patients also have lower rate of cardiac-related events including new myocardial infarction, recurrence of angina, severe arrhythmia, congestive heart failure requiring hospitalization and reoperations. Thus, total arterial revascularization for CABG may be beneficial for long-term outcome. The LITA, the right internal thoracic artery (RITA), the radial artery (RA), the right gastrepiploic artery (RGEA) and the inferior epigastric artery (IEA) can be used as arterial conduits. In this paper we review these arterial conduits and clinical results associated with their use in CABG.