Topic: Advances in Total Arterial Coronary Bypass Surgery

Coronary surgery remains primarily reliant on the use of saphenous vein graft to revascularize arterial coronary circulation. Multiple arterial grafting aims to supplement this strategy by increasing the use of arterial grafts. The only conduit known to fail progressively is the saphenous vein graft. Total arterial revascularization (TAR) adopts the opposite strategy of exclusive reliance on arterial grafts - specifically avoiding saphenous vein grafts.

Commonly held beliefs about increasing the use of arterial grafts tend to hinder their greater adoption due to concerns related to perceived higher risks, technical complexity, variations in perioperative management, or logistical requirements. While routine TAR will rely on complex reconstruction techniques in a minority of cases, most cases involving 2-4 grafts can achieve adequate revascularization using conventional techniques – simply substituting arterial conduits for venous conduits. Thus, the key obstacle to change appears to be resistance to change itself.

This Special Issue will explore clinical, angiographic, and logistical aspects related to the implementation of TAR. Additionally, it will address relevant issues pertaining to the broader adoption of TAR, such as the widespread use of the radial artery for diagnostic and interventional angiography. Finally, it will examine the practical skills required to effectively implement a program aimed at increasing the adoption of TAR within healthcare institutions.

30 Oct 2024