Coronary artery bypass graft surgery relieves angina symptoms and reduces mortality among ischaemic
heart disease patients. It remains the gold standard for the treatment of multi-vessel and
left main coronary artery disease. It is a well-known fact that internal mammary artery conduits have excellent and long-lasting patency when used for
coronary artery bypass grafting. Its supremacy is largely because it prevents
atherosclerosis. The old-style internal mammary artery bypass grafting, classically known as pedicle grafting, includes a circular rim of tissue around the graft. Bilateral pedicled internal mammary arteries, especially among diabetic patients, have been reported to cause complications in the sternum like sternal
osteomyelitis. In many studies it has been reported that dissection of pedicled internal mammary artery can lead to sternal devascularisation which can lead to higher incidence of
infections. Considering the higher incidence of deep sternal
infections in patients with double pedicled arterial grafts, dissection of internal mammary artery in skeletonised manner was proposed. In this review, we outline the advantages of skeletonised grafting with respect to incidence of sternal
infection, patency rates, blood flow, post-
coronary artery bypass graft
pain and the length of the graft.