Interval results with right gastroepiploic bypass

Right gastroepiploic artery bypass grafting has proved to be a viable surgical choice since the mid-1980s. Long-term graft patency, however, has been challenged ever since. We present 43 patients who underwent right gastroepiploic artery bypass surgery off pump with minimal invasive techniques with an average follow-up period of 57.9 months since 1996.

Operative methods are described and were confined to a subxiphoid incision. The series consists of 43 patients (38 male and 5 female) with an age range of 44 to 79 years. All patients had heart disease classified as Canadian Cardiovascular Society class III-IV and 35/43 (81.3%) of patients had undergone 1 to 3 reoperations. Postoperatively, 93% had no complications. Crude mortality was 2.3%, with an expected mortality of 4% and risk-adjusted mortality of 1.45%. Nine patients underwent combined procedures.

Of the 43 patients, 41 were alive at 57.4 months (range, 20-76 months). Results of Doppler studies and angiography proved 95.3% and 91.6% patency.

In this series, our highest-risk patients with reoperative coronary artery disease had low mortality and no intervention in this interval follow-up.