Introduction
Coronary artery bypass grafting (CABG) remains the preferred revascularization modality for the elective treatment of patients with complex three vessel coronary artery disease. The left internal mammary artery (LIMA) is routinely used for revascularization of the left anterior descending artery. However, the choice of conduit used in addition to the LIMA can be contentious. There is evidence that the use of additional arterial grafts such as right internal mammary artery (RIMA) and Radial Artery (RA); are associated with improved long-term patency. LIMA grafting to the left anterior descending (LAD) artery and use of a radial artery instead of the saphenous vein are Class I recommendations in the 2018 ESC/EACTS guidelines on myocardial revascularization. The use of bilateral IMA conduits is a Class IIa recommendation. Stenosis of arterial grafts can occur in some patients postoperatively. However, no reports have described an evaluation of conduit using optical coherence tomography (OCT) to ascertain the mechanism of stenosis. We describe the use of OCT in the evaluation of suspected conduit stenosis in Total Arterial Revascularisation.