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[Sequential coronary artery bypass using gastroepiploic artery]
T Koyanagi1, M Endo, A Shiikawa
1Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Insights
Sequential gastroepiploic artery (GEA) grafting offers a viable option for complex coronary artery bypass grafting, demonstrating high patency rates and no early mortality in a small patient cohort.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Coronary Artery Disease
Context:
- Coronary artery bypass grafting (CABG) is a standard treatment for severe coronary artery disease.
- Graft selection is crucial for long-term outcomes.
- The gastroepiploic artery (GEA) is an alternative autologous graft for CABG.
Purpose:
- To evaluate the feasibility and early outcomes of sequential in situ gastroepiploic artery (GEA) grafting.
- To assess the patency rate of sequential GEA grafts in patients requiring multiple coronary artery bypasses.
Summary:
- Seven patients underwent sequential GEA grafting for coronary artery bypass.
- Grafts were anastomosed sequentially to the right coronary artery and/or circumflex artery branches.
- No early deaths occurred, and postoperative angiograms showed a 92.3% graft patency rate (12/13 anastomoses).
Impact:
- Sequential GEA grafting provides an effective alternative when the internal thoracic artery is inaccessible.
- This technique is indicated for patients needing multiple coronary artery bypass grafting.
- High patency rates suggest GEA is a reliable option for complex revascularization.
Abstract:
We carried out sequential coronary bypass grafting using the gastroepiploic artery (GEA) as an in situ graft in seven patients. Four patients had sequential graft from the right coronary to the circumflex. Three patients were anastomosed to two or three peripheral branches of the right coronary artery. There were no early deaths. Postoperative angiograms revealed that the patency rate was 92.3% (12/13 anastomoses). Sequential GEA grafting is available to anastomose the peripheral branches of the right coronary and the circumflex where the in situ internal thoracic artery is difficult to access. Therefore, this procedure will be indicated for multiple coronary artery bypass grafting.