Bypass materials

The operation is performed classically through an incision over the breastbone (midline sternotomy) using the heart-lung machine. The leg veins and chest arteries are usually employed for the bypass grafts. The most important vessel used nowadays is the left internal mammary artery (IMA bypass, though the correct anatomical name is actually the internal thoracic artery; this arises from the brachial artery and is generally called the mammary artery) with a patency rate of 90% after 10 years. Bilateral use of the left and right mammary arteries is nearly standard, especially in young patients. If these arteries do not suffice for the operation, vein bypass grafts (ACVB) are also performed using the patient’s leg veins (long saphenous vein, patency rate: 50% after 10 years) or else the radial artery from the forearm (patency: 80% after 10 years).