Related Experiment Video
Updated: Sep 11, 2026
Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Coronary artery bypass grafting using the gastroepiploic artery in 1,000 patients
Hitoshi Hirose1, Atushi Amano, Shuichirou Takanashi
1Department of Cardiovascular Surgery, Kobari General Hospital, Noda City, Chiba, Japan. genex@nifty.com
Insights
The gastroepiploic artery (GEA) shows good short-term results for coronary artery bypass grafting. However, long-term GEA graft patency is lower than internal mammary arteries, requiring careful monitoring for angina.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Coronary Artery Disease Management
Background:
- The gastroepiploic artery (GEA) is a viable graft option for coronary artery bypass grafting (CABG).
- This study reviews clinical outcomes and long-term angiographic results of 1,000 patients who received GEA grafts.
Purpose of the Study:
- To evaluate the efficacy and long-term patency of the GEA as a graft in isolated CABG procedures.
- To compare GEA graft performance with other commonly used grafts, particularly internal mammary arteries.
Main Methods:
- Retrospective analysis of 1,000 consecutive isolated CABG procedures using GEA between 1991 and 2001.
- Assessment of perioperative data, late angiographic results, cardiac events, and survival rates.
- Follow-up endpoint defined as death or cardiac-related event.
Main Results:
- GEA was used predominantly in situ (99.6%), with high rates of anastomosis to the right coronary artery (87.8%).
- Hospital morbidity (10.8%) and mortality (0.8%) were acceptable, with no abdominal complications.
- Actuarial 5-year GEA graft patency was 84.4%, significantly lower than LIMA (97.0%).
- Actuarial 5-year survival rate was 92.6%, with 36 cardiac-related deaths.
Conclusions:
- GEA provides good perioperative outcomes in CABG.
- GEA graft patency is inferior to internal mammary arteries, necessitating vigilance for late graft failure and angina.
- Careful monitoring for late angina due to GEA graft failure is recommended.
Background:
The gastroepiploic artery (GEA) has been used as a graft in 1,000 patients in our institution, and the clinical outcome and the angiographic long-term results were reviewed.
Methods:
Between June 1, 1991, and June 30, 2001, 1,000 consecutive isolated coronary artery bypass grafting procedures using the GEA were performed in the Shin-Tokyo Hospital Group. The perioperative data were retrospectively analyzed, and the late angiographic results, cardiac related events, and survival were examined. The end points of the follow-up study were death or the occurrence of a cardiac-related event.
Results:
The GEA was used in 767 men and 233 women (mean age, 63.8 +/- 9.4 years). The GEA was used as an in situ graft in 99.6% of patients and was anastomosed to the right coronary artery in 87.8% and the circumflex artery in 10.0%. In addition, the left internal mammary artery was used in 96.9% of patients, the right internal mammary artery in 28.5%, the radial artery in 41.7%, the inferior epigastric artery in 1.4%, and the saphenous vein in 40.1%. The hospital morbidity and mortality rates were 10.8% and 0.8%, respectively. No abdominal complications were observed. Postoperative myocardial infarction associated with GEA graft failure occurred in 2 patients. During the late follow-up of 4.0 +/- 2.3 years, cardiac-related events were observed in 155 patients. The actuarial 3- and 5-year event-free rates were 91.2% and 84.2%, respectively. There were 86 late deaths, 36 of which were cardiac related deaths. The actuarial 3- and 5-year survival rates were 96.6% and 92.6%, respectively. Angiography was performed on 437 patients within 1 year after operation and in 221 patients more than 1 year postoperatively (mean interval, 3.1 +/- 1.8 years). The actuarial 1-, 3-, and 5-year GEA graft patency rates were 98.7%, 91.1%, and 84.4%, respectively, and the actuarial 1-, 3-, and 5-year LIMA graft patency rates were 99.6%, 98.8%, and 97.0%, respectively (p < 0.0005).
Conclusions:
The GEA was used for coronary artery bypass grafting with good perioperative results. However, the angiographic patency rate of the GEA was inferior to that of the internal mammary arteries. The late occurrence of angina attributed to GEA graft failure should be carefully monitored.
More Related Videos
09:12Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
05:25Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023