Total Arterial Myocardial Revascularization

Failure of saphenous vein graft conduits is the most common indication for coronary artery reintervention after coronary artery bypass surgery. To estimate the feasibility and efficacy of total arterial myocardial revascularization in our patients, routine use of pedicled bilateral internal mammary arteries with or without a radial artery was applied in our department for the past 7 years in 1825 consecutive patients. Total arterial revascularization was achieved in 1817 of 1825 consecutive patients (99.5%), with 5815 coronary anastomoses using only bilateral mammary arteries with or without a radial artery. Combined procedures were performed in 345 (18.9%) of the cases. Preoperative mean additive Euroscore was 7.4, and the early mortality rate was 2.6%. Regular use of both mammaries and radial artery in patients requiring myocardial revascularization is a feasible and efficient technique, and it is highly recommended as a gold standard.