Over the past 30 years, multi-arterial coronary artery bypass grafting techniques have been shown to be associated with improved patient outcomes compared to the current standard, single-arterial coronary bypass grafting technique, in the general patient population undergoing surgical coronary revascularization. Whether a survival benefit exists in high-risk patient sub-cohorts is less well defined, calling into question the value of the higher technical complexity of multi-arterial bypass grafting. Herein, we review the most current evidence for multi-arterial bypass grafting versus single arterial bypass grafting in several higher-risk patient cohorts. Discussion will focus on the two most common techniques for multi-arterial bypass grafting: the use of bilateral internal thoracic arteries and the use of the left internal thoracic artery in conjunction with the radial artery with or without supplemental saphenous vein grafts.
Schwann et al. (Thu,) studied this question.