Background: Total arterial revascularization in coronary arterybypass grafting (CABG) has recently become of great interest to manysurgeons. This strategy was adopted to overcome the problems of late veingraft atherosclerosis, occlusion and need of coronary reoperation (Tatouliset al., 1999).Objectives: This work is aiming to compare the results of total arterialrevascularization with conventional or mixed venous and arterialrevascularization as regards improvement of left ventricular functionand improvement of myocardial perfusion using myocardial perfusionimaging.Methodology: From July 2001 to June 2004, 44 patientsunderwent CABG they classified into two groups: Group I included 19patients underwent conventional CABG using arterial and venousconduits. Group II included 25 patients underwent total arterialrevascularization CABG. All the patients were followed-up for 42months for hard end points (cardiac death and non fatal myocardialinfarctions) and soft end points (need for revascularization or ICUadmission).Results: The mean age of all patients was 51.05 ± 8.2 years,ranging from 28 years to 65 years. The comparison of two groups asregard operative data showed that the group II patients had short crossclamping time, bypass time and number of conduits needed forrevascularization. The total number of conduits used for all patients was 116conduits, among the arterial conduits higher percentage of LIMA93.2% then radial artery 77.3% were used. The hard events occurred in11.4% of all patients. While soft events occurred in 23.7% of thepatients. The distribution of hard and soft events in both groups wascomparable except of revascularization which was higher in group IIthan in group I (28% versus 5.3%).Conclusions: This study concluded that: Patients with multi-vesselsdisease had many risk factors for CAD, smoking is the highest riskfactor. Conventional and total arterial grafting had similar immediateresults and outcome. Short term follow up showed no significantdifference between both techniques. Exercise MPI is the corner stonefor evaluating patients post CABG, not only for diagnosis of residualischemia but also for prognostic values.