Total arterial coronary myocardial revascularization with internal thoracic arteries to the left coronary system and radial artery to the right coronary artery.

Total arterial myocardial revascularization is still an uncommon surgical procedure and long-term survival benefits of revascularization with the radial artery in addition to bilateral internal thoracic arteries, have not been clearly defined.  In this video tutorial we present the case of a 63-year-old male with 3-vessel coronary artery disease, who underwent total arterial revascularization coronary artery bypass grafting with skeletonized Y-graft bilateral internal thoracic arteries to the left coronary system and the radial artery to the descending posterior artery. The postoperative course was uneventful and the patient was discharged on the 5th postoperative day. In selected patients, younger than 65 years old, with 3-vessel coronary artery disease, total arterial myocardial revascularization with the radial artery and bilateral internal thoracic arteries is safe, reproducible, and may confer excellent long-term results.