The TCRAT Technique (Total Coronary Revascularization via Left Anterior Thoracotomy): Renaissance in Minimally Invasive On-Pump Multivessel Coronary Artery Bypass Grafting?

ABSTRACT: Total Coronary Revascularization via left Anterior Thoracotomy (TCRAT) represents a modern evolution of sternum-sparing, on-pump multivessel coronary artery bypass grafting. In this review, we will summarize the historical development, detail the surgical principles, and provide a comprehensive overview of the clinical outcomes of TCRAT. The technique combines cardiopulmonary bypass using peripheral arterial as well as venous cannulation and cardioplegic cardiac arrest using transthoracic aortic cross-clamping with surgical access through a left anterior minithoracotomy. By applying special slinging and rotational maneuvers, both a stable exposition of all coronary territories-in particular those of the right and the circumflex coronary artery-and a quiet, bloodless operating field enable

SUBMITTER: Demianenko V 

PROVIDER: S-EPMC12841949 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature