Graft

In surgery, a graft is a piece of tissue or material that is transplanted from one location to another to repair, replace, or augment a damaged or absent structure. Grafts may be taken from the patient’s own body (autograft), from another person (allograft or homograft), from an animal (xenograft), or be made from synthetic material (prosthetic graft).

In cardiac surgery, the most common use of grafts is in coronary artery bypass grafting (CABG), where blood vessels harvested from elsewhere in the patient’s body are used to create new pathways that bypass blocked coronary arteries. The saphenous vein from the leg is the most commonly used bypass graft conduit, while the internal mammary artery (from the chest wall) provides superior long-term patency and is the preferred graft for the most important coronary artery (the left anterior descending artery). The radial artery from the forearm is also used.

In congenital heart surgery, homograft conduits (human donor vessels and valves) are frequently used to reconstruct the right ventricular outflow tract or to replace absent connections. Synthetic grafts made of polyester or PTFE are used in some aortic operations and certain congenital repairs.

For patients who have had cardiac arrest caused by coronary artery disease and subsequently undergo CABG, understanding the anatomy of their bypass grafts is important for future cardiac investigations and procedures. The surgical report will detail which grafts were used and which coronary arteries they supply.