Korean J Thorac Cardiovasc Surg.  2013 Jun;46(3):165-177. 10.5090/kjtcs.2013.46.3.165.

Conduits for Coronary Bypass: Arteries Other Than the Internal Thoracic Artery's

• Barner HB

• KMID: 1427786
• DOI: http://doi.org/10.5090/kjtcs.2013.46.3.165

Abstract

This is the third in a series on coronary artery bypass which reviews three alternative arterial conduits. The radial artery has become the most widely used of the three and accumulating experience demonstrates better patency at 10 years versus saphenous vein. Drawbacks are a long incision on the forearm, the propensity for spasm and persistent sensory disturbance in about 10%. The first is answered by endoscopic harvest which may yield a shorter conduit but reduces sensory nerve injury. Spasm is managed pharmacologically and by less harvest trauma. The gastroepiploic artery is used in situ and free and although the abdominal cavity is entered complications are minimal and patency compares favorably with the radial artery. Use of the inferior epigastric artery remains minimal and its similar length often requires composite use but limited patency data are supportive. Other arteries have had rare use and this is unlikely to change because the three presented here have significant advantages and acceptance.

Keyword

Coronary artery grafting; Radial artery; Gastroepiploic artery; Inferior epigastric artery

MeSH Terms

Abdominal Cavity
Arteries
Coronary Artery Bypass
Epigastric Arteries
Forearm
Gastroepiploic Artery
Radial Artery
Saphenous Vein
Spasm