There are several options for this. The three most commonly used conduits are segments of vein harvested from the leg, the internal mammary artery which runs inside the chest wall, and the radial artery located in your arms. Endoscopic vein harvesting is a new technique for retrieving vein from the legs using several small incisions instead of one continuous incision. This technique, when used, lessens some of the postop leg discomfort.

The internal mammary artery is freed up from the chest wall and has the advantage of retaining better patency because it is not removed from its source. The disadvantage is that it cannot reach all parts of the heart. We have recently started more frequent use of the radial artery in the arm as well and have had good results with this.