RIGHT GASTROEPIPLOIC-TO-CORONARY ARTERY BYPASS - THE FIRST DECADE OF USE

Citation
J. Pym et al., RIGHT GASTROEPIPLOIC-TO-CORONARY ARTERY BYPASS - THE FIRST DECADE OF USE, Circulation, 92(9), 1995, pp. 45-49
Citations number
27
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System",Hematology
Journal title
ISSN journal
0009-7322
Volume
92
Issue
9
Year of publication
1995
Supplement
S
Pages
45 - 49
Database
ISI
SICI code
0009-7322(1995)92:9<45:RGAB-T>2.0.ZU;2-J
Abstract
Background The right gastroepiploic artery was first used by us as a c oronary artery bypass graft (CABG) in June 1984 and has become an acce pted alternative conduit for myocardial revascularization. Methods and Results We have now performed this operation in 126 patients (111 of whom were men) aged 32 to 78 years. The right gastroepiploic artery wa s used as a pedicle graft to the right main coronary artery in 25 pati ents, to its posterior descending branch in 90, to a left ventricular branch in 2, to branches of the circumflex system in 6, and to the lef t anterior descending artery in 1. Free (aortocoronary) gastroepiploic grafts were placed to circumflex branches in 2 patients, There were 2 hospital deaths (stroke, arrhythmia), and mean+/-SD postoperative sta y was 7.5+/-2.0 days. All survivors were symptomatically improved and are functionally in New York Heart Association functional class I or I I. There have been 3 late deaths (at 34, 50, and 84 months) in 2 to 12 0 months of followup (mean, 41.4 months). Angiography of bypass grafts and coronary arteries was performed in 44 patients at 7 days to 80 mo nths postoperatively, providing direct evidence of gastroepiploic graf t patency in 34 patients and strong indirect evidence in another 6; ad equate data could not be obtained in 3 patients for technical reasons, and 1 graft was occluded. Conclusions These short-term, intermediate, and long-term results demonstrate the suitability of the right gastro epiploic artery as a CABG. The use of the right gastroepiploic artery as a graft to coronary arteries on the posterior wall of the heart, in conjunction with one or both internal mammary arteries, has the poten tial to allow complete myocardial revascularization with viable arteri al grafts.