Free compared with pedicled right internal thoracic arteries for coronary artery bypass grafting

Abstract

Bailey and Hirose [1] reported the use of the right internal thoracic artery (ITA) as a bypass graft in 1968. Shortly after its introduction, it became obvious that the pedicled right ITA could not always reach the appropriate target artery. Many surgical techniques were developed which aimed to maximize the length of the right ITA; for example, lengthening the pedicle by performing transverse fasciotomies, harvesting the ITA as a skeletonized graft, tunneling the graft through the transverse sinus and passing the graft anterior to the aorta across the midline to the left anterior descending artery (LAD) or diagonal [2-5]. In 1973, Barner et al. [6] and Loop et al. [7], independently of each..