Page 37 - Read Online

Royse et al. Vessel Plus 2020;4:5 Vessel Plus
DOI: 10.20517/2574-1209.2019.34

Commentary Open Access

Why and how to achieve total arterial
revascularisation in coronary surgery

Alistair Royse , Colin Royse 1,2,3 , Stuart Boggett , Sandy Clarke-Errey , Zulfayandi Pawanis 5
4
1
1,2
1 Department of Surgery, The University of Melbourne, Melbourne 3050, Australia.
2 Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne 3050, Australia.
3 Outcomes Research Consortium, the Cleveland Clinic, Cleveland, OH 44195, USA.
4 Statistical Consulting Centre, The University of Melbourne, Melbourne 3050, Australia.
5 Department of Cardiothoracic Surgery, Universitas Airlangga, Surabaya 60132, Indonesia.
Correspondence to: Prof. Alistair Royse, Department of Surgery, The University of Melbourne, Melbourne 3050, Australia.
E-mail: alistair.royse@unimelb.edu.au

How to cite this article: Royse A, Royse C, Boggett S, Clarke-Errey S, Pawanis Z. Why and how to achieve total arterial
revascularisation in coronary surgery. Vessel Plus 2020;4:5. http://dx.doi.org/10.20517/2574-1209.2019.34

Received: 11 Dec 2019 First Decision: 3 Jan 2020 Revised: 16 Feb 2020 Accepted: 27 Feb 2020 Published: 13 Mar 2020
Science Editor: Mario F. L. Gaudino Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Received: First Decision: Revised: Accepted: Published: x
Abstract
Science Editor: Copy Editor: Production Editor: Jing Yu
Single internal mammary artery and supplementary saphenous vein grafts (SVG) continues to be used in
approximately 95% of coronary surgery as of 2019. The late failure of SVG is very well documented yet remains
the predominant conduit used - why? The left internal mammary artery almost never fails, and late angiography
of patent radial artery grafts also appear entirely normal. Logic would suggest that avoiding the conduit known
to progressively fail would lead to improved late outcome. Our studies have demonstrated such findings in large
single centre and national registry datasets. We describe strategies to achievement of total arterial coronary
revascularisation.

Keywords: Total arterial revascularisation, radial artery, total arterial revascularisation, radial artery, Y graft

INTRODUCTION
This paper is intended to be a pragmatic guide including diverse considerations related to the attainment
of total arterial revascularisation. It is not a comprehensive review and limited discussion of some topics is
intended to provide a summary of a topic rather than an exhaustive review of the topic.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.vpjournal.net