The right gastroepiploic artery: an alternative conduit for myocardial revascularization

The initial experience in 18 patients undergoing coronary artery bypass surgery with the right gastroepiploic artery (RGEA) between April 1988 and August 1989 is reported. The indication for RGEA-use included the aim to obtain complete arterial revascularization in 15 patients and absence of suitable veins in 3 patients. Twelve patients had at least one previous CABG-operation. The average number of distal arterial anastomoses per patient was 2.5. The RGEA was connected to the right coronary artery (RCA) or its terminal branches in 13 patients, to the circumflex (CX) in 2 and sequentially to RCA and CX in 3 patients. In combination to the RGEA, 8 patients received bilateral internal mammary grafts and 6 patients received a single IMA-graft. There was one hospital death and there were no major early or late complications related to the RGEA-use. Postoperative angiographic controls in 16 patients revealed only one early RGEA-graft occlusion due to inadequate diameter and low run-off. There was one demonstrated late occlusion. These early results suggest that the RGEA can be used as an in situ graft to the posterior coronary vessels. Indications can be extended in function of the longterm patency and functional results.