Dear Mohammed,

you are right - the word total-arterial-revascularization is allover in cardiac surgery. But like in venous grafts there is "no need" so far for functional characterisation in terms of flow at the end of the procedure or anything else.

Best

Ralf

what I mean is a functional definition in sense of revascularization goal...for example, could I define a CABG procedure with LIMA to LAD, RIMA to RCA , Radial artery to 2 marginal ramus and a vein to diagonal ramus as a TAR (total arterial revascul.)?...I think anatomically no but functionally yes

I think the future is for hybrid revascularization , not total arterial. LIMA to LAD , PCI to other vessels .

Hi Mohammed, in my opinion the TAR approach aims on limiting incidences of peri-operative stroke combined with long-term patency of grafted vessels. Hence, TAR comprises of a LIMA to RIMA (or if necessary A. radialis) T-Graft procedure without touching the aorta for proximal graft insertion. On the other hand, it might be a safe alternative to the TAR approach to use a vein graft to the RCA/RIVP with performing arterial revascularization of LAD/D and RMOs.

i believe total arterial revascularization means an arterial graft in every territory needing revascularization, that is LAD, CX, and RCA. If an extra saphenous vein is added for another branch it must be considered TAR.

I guess the functional definition should be that type of revascularization that results in physiologically normal perfusion of all tissues threatened by ischemia because of arterial obstructions.

The significant stenosed coronary arteries are revascularised with arterial conduits like LIMA RIMA radial artery