Conclusions
Recent studies have demonstrated superior performance of RA as second
conduit for CABG34. Nevertheless, it remains unclear
whether its patency rate is related to correct indications (e.g.
critical coronary artery stenosis), less invasive and/or no-touch
harvesting techniques or to the use of antispasmodic drugs.
There are some evidences that support the use CB to ameliorate RA
patency24, however given the lack of large randomized
trials on the specific topic (CCB versus no-CCB), final conclusions and
recommendations cannot be drawn.
Importantly, the side effects of CB grafting are not negligible and
should be taken into account in clinical decision-making.
Finally, understanding the triggers and mechanisms that regulate RA
vessel tone and its response to endogenous and exogenous stimulation is
pivotal in optimizing RA use as bypass conduit.