The Growth Potential and Patency of Free Right Internal Thoracic Arteries Verified by Computed Tomography Angiography

Tadashi Isomura, Masanori Hirota, Minoru Yoshida, Shunsuke Yamagishi, Kohei Sumi, Shigehiko Yoshida

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: The use of the left internal thoracic artery (LITA) is the gold standard in coronary artery bypass graft surgery (CABG). Multiarterial grafting for CABG is being increasingly emphasized. This study aimed to resolve the utility of the right internal thoracic artery (RITA) for multiple CABG as “free” RITA and described new evidence. Methods: One hundred sixty-three patients received solo CABG with bilateral internal thoracic arteries between 2005 and 2018. The RITA was used as in situ RITA, group A (n = 62), and the composite graft created with saphenous vein graft (SVG), group B (n = 101). The patency rate and graft size of the composite free RITA and SVG were examined by coronary computed tomography angiography. Results: The average number of distal anastomoses per patient was 3.4 ± 1.0 in group A, and 4.2 ± 1.1 in group B (P <.001). The sequential grafting with free RITA was in 86 patients. The patency rate of both LITA and RITA was similar in both groups. In group B, 40 patients received late computed tomography angiography at a mean of 46 months (range, 17 to 175). The late patency rate was 95.1% in LITA and 96.9% in free RITA. The diameter of free RITA increased from 2.06 ± 0.34 mm to 2.37 ± 0.23 mm (P =.036); that of in situ LITA increased from 2.08 ± 0.51 mm to 2.44 ± 0.49 mm (P =.047); and that of composite SVG decreased from 4.1 ± 0.9 mm to 2.6 ± 0.7 mm (P <.001). Conclusions: Multiple bypass grafting can be sufficiently achieved with LITA and free RITA. The growth potential of free RITA and in situ LITA might play the important role of expected long-term patency.

Original languageEnglish
Pages (from-to)1990-1996
Number of pages7
JournalAnnals of Thoracic Surgery
Issue number6
Publication statusPublished - Dec 2021

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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