DOI: 10.36347/sjams.2018.v06i12.079

Pages: 5095-5100

Coronary Artery Bypass Grafting (CABG) remains a critical treatment for coronary artery disease (CAD), with the choice of conduit playing a significant role in determining long-term outcomes. This review explores the comparative efficacy of various graft conduits used in CABG, focusing on the Internal Thoracic Artery (ITA), Radial Artery (RA), Saphenous Vein Grafts (SVG), and Gastroepiploic Artery (GEA). Its aims to provide insights into the optimal conduit strategy for improving long-term revascularization success. The Left Internal Thoracic Artery (LITA) is considered the gold standard for coronary grafting, especially for Left Anterior Descending (LAD) artery grafting. Studies consistently report LITA grafts with 10-year patency rates exceeding 90%, far superior to SVGs, which often show patency rates below 50%. The Right Internal Thoracic Artery (RITA), although beneficial, has lower patency rates when used for Right Coronary Artery (RCA) grafting due to anatomical and technical challenges. This review critically evaluates conduit options for CABG, focusing on the comparative patency rates and clinical outcomes of grafts during the decade from 2007 to 2017. The Radial Artery (RA) is frequently used as a secondary arterial conduit, particularly for RCA grafting. While RA grafts show better long-term patency than SVGs, their use is limited by factors such as spasm and smaller vessel caliber. Bilateral Internal Thoracic Artery (BITA) grafting offers improved graft patency and survival, although it carries a higher risk of early complications like sternal wound infections. Arterial conduits, including the ITA and RA, are preferred in diabetic patients due to their superior resistance to atherosclerosis and long-term patency. Harvesting techniques, such as skeletonized grafting, further enhance graft patency. In conclusion, LITA remains the conduit of choice for LAD grafting, while RA and BITA offer valuable alternatives depending on patient-specific factors. Arteria