Total Arterial Revascularization: Achievable and Prognostically Effective—A Multicenter Analysis

Abstract

TAR is associated with low perioperative mortality and, importantly, improved long-term survival and could be used more liberally.

Multi‐arterial and total‐arterial coronary revascularization: Past, present, and future perspective

“…Similar results were reported in a large retrospective analysis of almost 35 000 patients by Tatoulis et al, 72 who found a significantly higher 30‐day and 10‐year mortality in non‐TAR patients (0.8% and 7.5%, respectively) when compared to TAR patients (1.8% and 8.9%, respectively); ( P < 0.001 for both comparisons)—with several different combinations of arterial conduits in the TAR group (11 948 LITAs; 2714 RITAs; 9935 RAs; 2235 composite T/Y grafts). Of note, the rate of DSWI was similar in the two groups: 0.7% in the TAR group and 0.6% in the non‐TAR group ( P = 0.38).…”

Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

“…Studies were excluded for the following reasons: no comparison between TAR and non‐TAR strategy (n = 32), sample population derived from a previously published and included series (n = 1), and lack of propensity score matching (n = 1). Consequently, 18 articles were included in our study . Mean age and mean body mass index of the included populations were 65.6 years (±7.6) and 27.1 (±1.7).…”

“…Consequently, 18 articles were included in our study. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Mean age and mean body mass index of the included populations were 65.6 years (±7.6) and 27.1 (±1.7). Thirty percent of the population presented with diabetes and 18.9% were female patients (Table S1).…”

“…For this reason, they were assigned to the category "TAR with BIMA". 16,17,[21][22][23][25][26][27]30,31 The remaining 4 studies were categorized as "TAR without BIMA" 19,20,29,32 (Figure 1). The percentages of patients of the TAR group receiving BIMA in these four studies were: Buxton 2012 = 16% 19 ; Buxton 2014 = 36% 20 ; Royse = 0% 29 ; and Tatoulis = 22%.…”

“…The percentages of patients of the TAR group receiving BIMA in these four studies were: Buxton 2012 = 16% 19 ; Buxton 2014 = 36% 20 ; Royse = 0% 29 ; and Tatoulis = 22%. 32 Six studies of the non-TAR group received a second artery conduit, besides LIMA, (Buxton 2012, RIMA = 11% 19 ; Formica, RIMA = 100% 21 ; Mohammadi, RIMA = 100% 25 ; Navia, radial artery = 75% 27 ; Shi, RIMA = 100% 30 ; Suzuki, RIMA = 30%; and gastroepiploic artery = 14% 31 ). Of these, three proposed a comparison between BIMA plus radial artery (TAR group) versus BIMA plus saphenous graft (non-TAR group): Formica, 21 Mohammadi, 25 and Shi.…”