The internal mammary artery – use as a free graft in coronary artery bypass grafting – evidence, technical considerations and controversies

Manoraj Navaratnarajah, Fadi Ibrahim Al-Zubaidi, Shahzad G. Raja, Department of Cardiac Surgery, St Thomas Hospital, Department of Cardiac Surgery, John Radcliffe Hospital, Department of Cardiac Surgery, Harefield Hospital

Perfusion

Published online on November 06, 2025

Abstract

Perfusion, Volume 41, Issue 5, Page 535-546, July 2026.
BackgroundIn-situ internal mammary artery (IMA) grafting remains the gold standard in coronary artery bypass grafting (CABG), particularly for left anterior descending artery revascularisation. However, the role of free-IMA grafts—especially free right ...