Using two internal mammary arteries aims to maximize long-term graft durability because arterial conduits stay patent longer and resist atherosclerosis better than vein grafts. This benefit often translates into improved long-term survival, especially in younger patients with a longer expected remaining lifespan who will live with the grafts for many years. But harvesting both mammaries increases the extent of chest wall dissection, raising the risk of sternal wound complications, including infection and mediastinitis. That risk tends to be higher in patients with diabetes, obesity, COPD, or poor wound healing, and it can offset the long-term gains in certain individuals. Therefore, the rationale hinges on selecting patients who are likely to derive meaningful long-term benefit from the superior patency of arterial grafts while weighing them against the higher risk of sternal wound problems. In some patients, a single LIMA to the LAD provides most of the durable benefit with a lower infection risk, and additional grafts can be planned to minimize wound complications. Techniques such as skeletonized harvesting can reduce wound risk and may expand BIMA use in select cases, but the basic trade-off remains: better long-term graft patency and potential survival benefit with BIMA, balanced against a higher risk of sternal wound complications requiring careful patient selection.

HDL is the “good” cholesterol, and higher levels help remove cholesterol from arterial walls, reducing atherogenic risk. Because of this protective role, a practical goal in lipid management is to keep HDL above 40 mg/dL. Levels at or below this point are associated with higher cardiovascular risk, while higher levels confer added protection. While some populations may benefit from even higher targets (for example, women often have higher HDL and guidelines sometimes advocate aiming higher in certain groups), the commonly used general target in many questions and guidelines is greater than 40 mg/dL. The other options either set a too-low threshold or imply a higher target that isn’t universally established as the standard goal.

Participation in cardiac rehabilitation after CABG is encouraged because a structured program, started once medically cleared, supports recovery, improves functional capacity, and reduces future cardiovascular risk. Rehab combines supervised aerobic and resistance exercise with education on risk factor modification, medication adherence, nutrition, smoking cessation, and stress management, all tailored to the individual's healing stage and fitness level. Starting rehab soon after discharge is the standard approach to help patients regain independence and return to daily activities, rather than waiting a full year. Exercise is a central, safe component when properly prescribed and monitored, so saying exercise is contraindicated is not correct. Likewise, rehab is not reserved only for a year after surgery, making the other statements incorrect.

Complete revascularization in CABG means bypassing all coronary regions with significant disease so that every area of myocardium at risk receives an adequate blood supply. The aim is to restore perfusion to all major diseased territories rather than addressing just a single culprit lesion. This approach matters because when all significant blocks are grafted, the heart muscle has better overall blood flow, which tends to reduce ongoing ischemia, lessen the likelihood of recurrent angina, and improve long-term survival. In real-world practice, surgeons may stage or tailor the plan, addressing the most critical areas first or when patient risk is high, then treating additional territories later or using hybrid strategies. The concept balances achieving as complete a revascularization as feasible with the patient’s safety, anatomy, and overall condition.