The superiority of left internal thoracic artery (LITA) grafting to the left anterior descending artery (LAD) is well established. Patency rates of 80%–90% have been reported at 10-year follow-up. However, the superiority of sequential LITA grafting has not been proven. Our aim was to compare patency rates after sequential LITA grafting to a diagonal branch and the LAD with patency rates of LITA grafting to the LAD and separate vein grafting to a diagonal branch.

Introduction: The superiority of LITA grafting to the LAD has been well established over the last decades. Patency rates of 80–90% have been reported at 10 and 15 years follow up. The superiority of sequential LITA grafting has not been proven. Our aim was to compare the patency rates after sequential LITA grafting to a Diagonal branch and the LAD with the patency rates after separate LITA grafting to LAD and vein grafting to a Diagonal branch.