Bilateral Internal Thoracic Artery Graft in Coronary Artery Bypass Grafting

Percutaneous coronary intervention is the first choice for treating simple coronary artery lesions because of the progress of coronary stents in recent years. Coronary artery bypass grafting is recommended for patients with multiple, diffuse and severely diseased coronary lesions. The most important goals of coronary artery bypass grafting are complete revascularization and long-term graft patency without reintervention. The left internal thoracic artery has demonstrated superior graft patency and provided excellent clinical results compared with saphenous vein graft. Moreover, bilateral internal thoracic artery grafting has better survival benefits than single internal thoracic artery grafting and patency rates and survival benefits are satisfactory when bilateral internal thoracic artery grafts are used. However, bilateral internal thoracic artery use rate remains low for reasons including the complexity of graft configuration and risk of sternal wound infection. This review aims to address the advantages and disadvantages of using the bilateral internal thoracic artery in coronary artery bypass grafting.