Arterial grafting for myocardial revascularization: how better is it?
OBJECTIVE
Arterial conduits are becoming popular in cardiac surgery. Clinical studies and long-term follow-ups have proven that this technique provides satisfactory long-lasting results. The purpose of this review is to give an overview of the main articles from recent literature and compare the latest results.


RESULTS
Arterial conduits are currently used in cardiac surgery and clinical follow-ups are confirming some advantages in performing multiple arterial revascularization compared to the saphenous vein and the mammary artery. Mid-term follow-ups are encouraging the use of the radial artery as the second conduit of choice after the internal mammary artery. Moreover, off-pump cardiac surgery is an alternative to perform extensive myocardial revascularization in selected patients. Use of in-situ mammary arteries and off-pump surgery has already been described as the ideal solution to guarantee the 'no touch aorta technique'. Recent results lead us to use the radial artery and the gastroepiploic artery as complement composite grafts to perform total arterial myocardial revascularization during off-pump coronary surgery.


CONCLUSIONS
Arterial grafting provides satisfactory results. The second graft of choice after the mammary artery is the radial artery, but long-term results are still not available. To reduce the risk of major neurological complications, selected patients benefit from off-pump arterial revascularization.
Ferrari
Enrico Riccardo
ER
Department of Cardiovascular Surgery, Centre Hôpitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. enrico.ferrari@chuv.ch
von Segesser
Ludwig Karl
LK
D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000601:surgery*; D003331:Coronary Vessels / Q000637:transplantation*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008323:Mammary Arteries / Q000637:transplantation*; D009204:Myocardial Revascularization / Q000379:methods*; D017534:Radial Artery / Q000637:transplantation*; D012501:Saphenous Vein / Q000637:transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome