What is the ideal vessel used for a triple or quadruple coronary artery bypass grafting (CABG)?

The ideal vessel for a triple or quadruple coronary artery bypass grafting (CABG) is the internal mammary artery. This artery is particularly favored due to its high patency rates and cardiovascular benefits. When used in coronary artery bypass grafting, the internal mammary artery often remains patent longer than vein grafts, which translates to improved long-term outcomes, such as reduced rates of recurrent angina and the need for additional interventions.

The internal mammary artery also has a natural blood supply and, being an arterial graft, tends to be more resistant to atherosclerosis compared to the greater saphenous vein, which is a common alternative. While the greater saphenous vein is frequently used in bypass procedures due to its accessibility, its long-term patency is not as favorable as that of the internal mammary artery.

Radial arteries are another option for grafting, but they are less commonly used in CABG compared to the internal mammary artery, which is often the first choice for left-sided coronary artery disease. Subclavian arteries are not used in CABG due to their potential complications and the availability of better-suited graft options.

In summary, the internal mammary artery is considered the ideal vessel for CABG