Abstract
The saphenous vein (SV) has been widely used as an aortocoronary bypass graft for coronary artery bypass grafting (CABG) for the past 60 years. However, CABG using the SV as an aortocoronary bypass graft has shown disadvantages of lower long-term graft patency rates and subsequently worse clinical outcomes, compared with CABG using the internal thoracic artery (ITA). Revascularization using an arterial composite graft based on the in-situ ITA increases the length of the arterial graft and allows the extensive use of arterial conduits to revascularize both the left and right coronary territories. In contrast to the arterial conduits which have been commonly used as composite graft configurations in patients exhibiting multi-vessel disease, the SV has not been widely used as a composite graft for CABG because there are concerns when using the SV having disadvantages as a composite graft. In this article, a recent surgical strategy of using the SV as part of a composite graft based on the in-situ ITA will be discussed.
