Coronary artery bypass grafting (CABG) is one of the most commonly performed operations worldwide and has been established as an effective treatment for symptomatic multivessel coronary artery disease (CAD). The standard surgical approach for CABG involves anastomosis of the left internal mammary artery (LIMA) to the left anterior descending artery (LAD), or the use of a saphenous vein graft (SVG) or radial artery (RA) graft to bypass other coronary arteries. However, an artery needs to be harvested to bypass an artery, and additional arteries are needed for more bypasses. The procedure is termed total arterial CABG. In recent years, bilateral internal mammary artery (BIMA) grafting has been used for patients
undergoing surgical coronary revascularization for multivessel disease.
Compared with single internal mammary artery (SIMA) grafting, BIMA grafting has greater late cardioprotective effects.
Using both internal mammary arteries and radial arteries for CABG confers better long-term results for patients.