SRS277 - Investigating the short-term outcomes of total arterial revascularisation: a look into donor site morbidity

Abstract Background Total Arterial Revascularisation (TAR) has demonstrated superior long-term outcomes compared to conventional coronary artery bypass grafting (CABG) techniques. However, its adoption remains limited due to concerns about operative complexity and short-term complications; especially donor site morbidity. Methods A retrospective audit was conducted on 111 patients who underwent TAR at a single centre between January and December 2023. Data for 108 patients were analysed, assessing demographics, comorbidities (for example diabetes, hypertension), and perioperative complications including donor site morbidity, infection, and wound issues. Results While 65% of patients experienced no complications, 35% reported issues such as shoulder pain and numbness (30%), chest pain (18%), and thoracotomy site infection (12%). Donor site discomfort, particularly associated with radial artery harvesting, was a key concern. Comorbidities like diabetes and smoking were linked to increased complication rates, emphasising the importance of risk stratification and prehabilitation. Conclusions TAR is a feasible and generally safe option for CABG with favorable short-term outcomes for most patients. Nonetheless, donor site morbidity remains notable. Improved surgical technique and patient optimisation especially targeting modifiable risk factors-may mitigate these complications. Recommendations Enhanced preoperative risk management, refined radial artery harvesting techniques, and prospective comparative studies with conventional CABG are recommended to optimise outcomes and broaden TAR applicability.