Total Arterial Revascularization (TAR) is an advanced surgical technique used in coronary artery bypass grafting (CABG) where only arterial grafts are used to bypass blocked coronary arteries, instead of using the traditional combination of arterial and venous grafts. This approach offers several advantages over conventional CABG, including better long-term patency, improved blood flow, and reduced risk of graft failure. The most commonly used arteries in TAR are the internal mammary arteries (left and right), radial artery, and sometimes the gastroepiploic artery. Arterial grafts are more resistant to atherosclerosis compared to venous grafts, which translates into superior long-term outcomes and fewer repeat interventions.

Dr. Saurabh Juneja, a renowned cardiothoracic and vascular surgeon, emphasizes the importance of TAR in improving survival rates and quality of life in patients with multi-vessel coronary artery disease. According to Dr. Juneja, careful patient selection, meticulous surgical technique, and thorough preoperative assessment are critical for achieving optimal results with TAR. He highlights that the use of bilateral internal mammary arteries (BIMA) provides excellent long-term results, especially in younger patients with good life expectancy. Additionally, TAR reduces the need for re-intervention and lowers the chances of recurrent angina or myocardial infarction.

However, TAR requires expertise and experience, as it is technically more demanding than conventional CABG. Dr. Juneja advocates for the wider adoption of TAR in suitable patients, as growing evidence supports its benefits over traditional methods. With continuous advancements in surgical techniques and perioperative care, TAR is emerging as the gold standard in coronary artery bypass surgery, offering patients a better and longer-lasting solution to coronary artery disease.