[Current experience of myocardial revascularization with arterial bypasses]

A considerable amount of experience has been accumulated with arterial bypass grafting of the coronary arteries. Long-term results with the internal mammary artery graft have demonstrated that atheromatous complications are rare, permeability rate is high, post-operative cardiac events unusual and survival improved. These excellent results have encouraged wide use of arterial grafts and incited surgeons to try increasing the number of bypasses with arterial grafts. Current research is aimed at determining the beneficial effect of bilateral grafting and extensive use of the mammary artery with sequential and Y anastomoses. Other analogous arteries, used in situ or as free grafts. The most promising results have been obtained with the gastro-epiploic, the epigastric and the radial artery. Long-term results in patients with venous grafts alone demonstrate that in the future myocardial revascularization surgery will be based on the use of arterial grafts although a consensus on the exact nature and strategy of the operation remains to be established.