Purpose of review: Coronary artery bypass grafting is a preferred strategy for complete coronary revascularization in patients who have multi-vessel coronary artery disease, left ventricular dysfunction, and/or diabetes. Both arterial (internal thoracic artery/radial artery) and venous grafts are utilized to bypass the obstruction in native vessels. Despite having radial arterial grafts as a preferred second conduit for bypass, venous grafts are more commonly used.
Recent findings: We review the existing literature and report the preferred conduit based on a recently published meta-analysis of 6 randomized controlled trials. The analysis concluded that radial artery grafts are associated with fewer adverse cardiac events and better graft patency at 5 years of follow-up. Although saphenous vein grafting is the most commonly used conduit in addition to ITA, current data suggests that total arterial bypass (using RA conduit in addition to ITA) may be the better strategy. Both the US and European consensus guidelines advocate for the use of arterial over SV grafting for most patients.
Keywords: CABG; Coronary artery bypass grafting; Graft failure; Graft patency; Radial artery graft; Saphenous venous graft.