Conduits Used in Coronary Artery Bypass Grafting: A Review of Morphological Studies

Ann Thorac Cardiovasc Surg. 2017 Apr 20;23(2):55-65. doi: 10.5761/atcs.ra.16-00178. Epub 2017 Feb 14.

Abstract

There is a significant variety of vascular conduits options for coronary bypass surgery. Adequate graft selection is the most important factor for the success of the intervention. To ensure durability, permeability, and bypass function, there must be a morphological similarity between the graft and the coronary artery. The objective of this review was to analyze the morphological characteristics of the grafts that are most commonly used in coronary bypass surgery and the coronary arteries that are most frequently occluded. We included clinical information regarding the characteristics that determine the behavior of the grafts and its permeability over time. Currently, the internal thoracic artery is the standard choice for bypass surgery because of the morphological characteristics of the wall that makes less prone to developing atherosclerosis and hyperplasia. The radial and right gastroepiploic arteries are the following second and third best options, respectively. The ulnar artery is the preferred choice when other conduits are not feasible.

Keywords: conduits; coronary artery bypass grafting; histology; morphology; permeability.

Publication types

  • Review

MeSH terms

  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / methods*
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / surgery*
  • Coronary Vessels / physiopathology
  • Coronary Vessels / surgery*
  • Gastroepiploic Artery / physiopathology
  • Gastroepiploic Artery / surgery*
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Humans
  • Mammary Arteries / physiopathology
  • Mammary Arteries / transplantation*
  • Radial Artery / physiopathology
  • Radial Artery / transplantation*
  • Risk Factors
  • Saphenous Vein / physiopathology
  • Saphenous Vein / transplantation*
  • Treatment Outcome
  • Ulnar Artery / physiopathology
  • Ulnar Artery / surgery*
  • Vascular Patency