Background: Recurrence of symptoms and the need for repeat interventions remains a clinical challenge following coronary artery bypass surgery, despite excellent early results. Saphenous vein graft failure has been identified as a main contributing factor to unsatisfactory long-term results. The use of multiple arterial grafts instead of venous grafts appears to be a promising treatment modality. This article describes our own experience with arterial revascularisation and gives a critical review of the literature.
Material and methods: Extended arterial revascularisation was performed in 30 patients at our institution between 1998 and 2001. Clinical follow-up was performed in all patients; re-angiography was done in six patients. 23 patients were operated on with bilateral mammary arteries; 11 patients received radial artery grafts.
Results: The median follow up was 12 months. All patients are alive, none suffered a new myocardial infarction. Our results are in accordance with the published literature.
Interpretation: Arterial grafting is a valuable tool in the armamentarium of modern coronary artery bypass surgery. Large randomised trials are required to clarify the role of extended arterial grafting in routine coronary bypass surgery.