since its introduction into the recommendations, left internal mammary artery use became a quality control measure for CABG surgery [1,2]. LIMA to left anterior descending artery grafting can improve patients survival compared with use of an SVG. Initially patients with double IMA grafts can be at greater risk group before operation, but on 10-yeyar follow-up period their survival rate was similar to that of patients with a single IMA graft [3]. Arterial grafting of the non–left anterior descending vessels, in patients undergoing isolated coronary artery bypass graft surgery with LIMA to left anterior descending artery, can improve a 15 years survival rate compared with SV grafting [4]. Regarding to conclusion of Iribarn A., et al., BIMA grafting reduces a risk of repeat revascularization and improves long-term survival and should be considered more frequently during coronary artery bypass grafting [5]. BIMA grafting to non-LAD coronary arteries received a class IIa recommendation (level of evidence grade B) by the American College of Cardiology Foundation/ American Heart Association guidelines for CABG, to improve survival and decrease reintervention rates [6]. Endo M., et al., suggest that the use of BIMA grafts in patients with in situ coronary artery anastomoses conferred to a significantly higher rate of freedom from repeated CABG in all patients compared with the use of SIMA [7]. Ravaux JM et al., in his study underlined that obesity, age, and diabetes treated by insulin (or not) does not influence of developing sternal wound infection or reintervention for postoperative bleeding (RIB), although, mortality was higher in RIB group [8].The advantage of BIMA grafts versus SIMA grafts has been a controversial topic, although the use of skeletonized BIMA grafts in coronary revascularization has recently been shown to produce better outcomes than use of SIMA grafts [9].
