Coronary artery disease continues to be a lethal threat to individuals worldwide. One of the most common treatment options for coronary artery disease is coronary artery bypass grafting [CABG]. During a CABG procedure, arteries or veins are harvested from different parts of the body and used to restore blood flow distal to the blockage from the aorta. The gold standard bypass conduit is the left internal thoracic artery [LITA] and using it to graft the left anterior descending artery of the heart is a well-established practice. However, there is no set guideline for conduits to use in conjunction with the LITA and there is a lot of variability in clinical practice as a result. Saphenous veins remain the most common graft conduit used; however, it has the lowest patency rate which leads to graft failure and has sparked the search for a better option. To date, the right internal thoracic artery, the radial artery, and the right gastroepiploic artery have been studied as coronary bypass graft conduits.
The goal of this project was to investigate the different types of bypass conduits by performing a detailed literature review to determine the second-best choice for coronary artery bypass conduit behind the LITA. The literature review was completed through the PubMed database using search terms such as 'coronary artery bypass grafts', 'coronary revascularization', 'saphenous vein graft', 'radial artery graft' and 'right internal thoracic artery'. A total of 53 studies were included in the review, and were organized by randomized control trials, observational studies, and propensity matched studies. Papers were then grouped by the types of conduits included in the study. As a result of the review, it was concluded that arterial conduits seem to provide better patient outcomes than venous and should be used when it is an available option.
