This is a prospective, randomized, double-blind controlled trial comparing the clinical efficacy of total arterial grafting (internal thoracic artery and radial artery) versus conventional mixed grafting (internal thoracic artery and great saphenous vein) in the left coronary artery system during coronary artery bypass grafting (CABG). A total of 400 patients undergoing elective CABG at the Second Hospital of Jilin University will be enrolled and randomized into two groups. The primary endpoint is graft patency at 12 months postoperatively, evaluated by coronary angiography or CT angiography. Secondary outcomes include perioperative complications, major adverse cardiovascular events (MACE), and long-term clinical prognosis. The study aims to provide evidence-based guidance on optimal graft selection in CABG.
Age ≥ 18 years
Diagnosed with multivessel coronary artery disease
Indicated for elective coronary artery bypass grafting (CABG) involving ≥3 coronary vessels
Right coronary artery stenosis >75%
Scheduled for concurrent cardiac procedures (e.g., valve surgery, congenital heart disease repair, aortic dissection surgery, atrial fibrillation ablation)
Severe stenosis of left or right subclavian artery
Unsuitable saphenous veins (e.g., bilateral varicosities)
Unsuitable radial artery as assessed preoperatively