Current trends in selection of conduits for coronary artery bypass grafting

• Published in: General thoracic and cardiovascular surgery Vol. 65; no. 10; pp. 549 - 556
• Main Authors: Carrel, Thierry, Winkler, Bernhard
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.10.2017; Springer Nature B.V
• Subjects: Angina pectoris; Cardiac Surgery; Cardiology; Coronary Artery Bypass - methods; Coronary Artery Disease - physiopathology; Coronary Artery Disease - surgery; Coronary vessels; Current Topics Review Article; Endothelium; Heart attacks; Heart surgery; Humans; Hyperplasia; Mammary Arteries - physiopathology; Mammary Arteries - transplantation; Medicine; Medicine & Public Health; Patients; Radial Artery - physiopathology; Radial Artery - transplantation; Saphenous Vein - physiopathology; Saphenous Vein - transplantation; Smooth muscle; Surgical Oncology; Thoracic Surgery; Thrombosis; Treatment Outcome; Vascular Patency - physiology; Veins & arteries; Vein graft; Patency rate; Internal thoracic artery; Coronary artery bypass grafting; Radial artery
• ISSN: 1863-6705; 1863-6713; 1863-6713
• DOI: 10.1007/s11748-017-0807-8

The procedure of coronary artery bypass grafting continues to be the “gold standard” for patients with multivessel coronary artery disease and left main stenosis due to favourable long-term and consistent outcomes despite the advent of new generations of stents. But the targeted better long-term outcome of surgical revascularization over percutaneous interventions depends on several variables and aspects; one of them is the choice of conduits used to bypass the stenosed arteries. Coronary artery bypass surgery has been studied and debated for decades and the same applies to the selection of grafts. Current data provide significant benefits for patients who receive full arterial revascularization using both internal thoracic arteries and, if applicable, the radial artery. Unfortunately, the use of multiple arterial grafts is still not performed widely despite the evidence of superiority over multiple saphenous vein grafts that are still the most used grafts in cardiovascular procedures. In this review article, we present current trends and evidences for graft selection and give an overview of controversial data regarding the comparison of the radial artery and saphenous vein. Additionally, few words are spelt on alternative conduits.