Coronary artery bypass conduits: Review of current status

Coronary artery bypass grafting (CABG) is the most common procedure performed in adult cardiovascular surgery today. In our Department of Surgery at Baylor College of Medicine, we have experienced, as have most large programs, a trend to older patients, more comorbidity, worse ventricular function, and more redo CABG procedures. Along with this shift has come an evolution in surgical techniques, cardioplegia and choice of coronary bypass graft conduits. The benefit of using an internal mammary artery (IMA) to the left anterior descending coronary artery (LAD) appears irrefutable at this time. Data for multiple arterial grafts is still evolving and conduit choice for other than the IMA to LAD graft is often debated. The purpose of this article is to review the current literature on conduit choice and to allow a rational, data driven approach to graft choice.