No cut on leg or hand
Total arterial coronary revascularization is an advanced form of CABG in which arterial grafts are used to bypass diseased coronary arteries, reducing or avoiding the use of vein grafts when appropriate.
Why are arterial grafts used?
Arterial grafts generally have excellent long-term durability compared with saphenous vein grafts. The Left Internal Mammary Artery (LIMA) is particularly well established for bypassing the LAD.
In selected patients, both internal mammary arteries—LIMA and RIMA—may be used to achieve more extensive arterial revascularization.
What is LIMA–RIMA Y grafting?
In a Y-graft configuration, one arterial graft is connected to another artery to create multiple pathways for blood flow to different coronary territories.
This technique can allow extensive arterial revascularization while using the patient’s own arterial conduits.
Who may benefit?
Total arterial revascularization may be considered particularly in selected patients who:
- Have multivessel coronary artery disease
- Have a longer expected life expectancy
- Have suitable coronary anatomy
- Have suitable internal mammary arteries
- May benefit from avoiding or reducing the use of vein grafts
However, it is not appropriate for every patient. Diabetes, obesity, smoking, poor sternal healing risk and other factors may influence the choice of grafts.
How effective is it?
Arterial grafts can provide excellent long-term patency, but outcomes depend on patient selection, surgical technique, coronary anatomy and long-term risk-factor management.
Dr. Deepi Agrawal Goyal
Dr. Deepi has specialized training and clinical experience in advanced coronary surgery, including arterial revascularization techniques. Her approach is individualized, with graft selection based on coronary anatomy, patient characteristics and long-term goals rather than using one technique for every patient.