Optimal use of arterial grafts during current coronary artery bypass surgery.

Multiple arterial grafting, including the use of the bilateral internal thoracic arteries (ITAs), has strong benefits on patient clinical outcomes after coronary artery bypass grafting (CABG) but is far from commonly accepted at present. We reviewed the previous randomized and leading observational studies and assembled an up-to-date profile on multiple arterial grafting. Many of the previous trials successfully showed the beneficial effects of arterial grafting after CABG. Although many of these were retrospective studies, the data presented, mostly from world-famous surgeons, show that multiple arterial grafting does have advantages with regard to the long-term patient outcome without increasing rates of early mortality or morbidity. However, it is true that some surgeons experience a certain amount of stress when using multiple arterial conduits. Multiple arterial reconstruction has a strong advantage for patients undergoing CABG and is now a standard worldwide strategy. Surgeons nowadays need to make efforts to master arterial conduit techniques properly to provide state-of-the-art CABG to patients.