ObjectiveTo compare mid-to long-term outcomes of selective coronary venous bypass grafting (SCVBG) using internal mammary artery (IMA) grafts and great saphenous vein (GSV) grafts for surgical treatment of diffuse right coronary artery atherosclerosis. MethodsWe retrospectively analyzed clinical data of 75 patients undergoing SCVBG in Beijing Anzhen Hospital from January 2003 to December 2012. GSV was used as grafts for SCVBG in 54 patients (GSV group), and IMA was used as grafts for SCVBG in 21 patients (IMA group). All the patients were followed up in November 2013. Their survival condition, recent relapse rate of angina, recent echocardiographic results and coronary CT angiography (CTA) were analyzed. ResultsOverall survival rate of IMA group was slightly higher than that of GSV group (100.0% vs. 83.3%), but survival curves showed no statistical difference in survival rate between the 2 groups (P=0.055). Coronary CTA showed significant blockage in GSV grafts and middle cardiac vein in patients in GSV group (n=39), while IMA grafts and middle cardiac vein in patients in IMA group (n=18) were mostly visible and patent (P < 0.001). Left ventricular ejection fraction (LVEF) of the 2 groups were significantly higher than preoperative values, but there was no statistical difference between the 2 groups. ConclusionCompared with SCVBG using GSV, SCVBG using IMA can significantly improve mid-to long-term patency of the grafts and middle cardiac vein, and is an efficacious procedure for diffuse right coronary artery atherosclerosis.