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[Sequential coronary artery bypass using right gastroepiploic artery]
S Iwabuchi1, K Takahashi, A Narita
1Department of Cardiovascular Surgery, Aomori Rosai Hospital, Hachinohe, Japan.
Insights
Sequential arterial grafting using the right gastroepiploic artery (RGEA) is effective for multiple coronary artery bypass grafting. This technique achieved a high patency rate and improved patient outcomes, demonstrating its clinical utility.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Coronary Artery Disease
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for severe coronary artery disease.
- Arterial grafts, such as the right gastroepiploic artery (RGEA), offer long-term patency compared to venous grafts.
- Sequential grafting techniques aim to maximize the use of available arterial conduits.
Purpose of the Study:
- To evaluate the efficacy and safety of sequential coronary artery bypass grafting using the right gastroepiploic artery (RGEA).
- To assess the patency rates and clinical outcomes of RGEA sequential grafts in patients requiring multiple arterial bypasses.
Main Methods:
- A retrospective review of 17 patients who underwent sequential RGEA grafting between January 1989 and March 1993.
- Detailed description of various sequential anastomoses performed, including RGEA to target coronary arteries.
- Postoperative angiographic assessment of graft patency in 16 patients.
Main Results:
- A total of 33 anastomoses were performed across the 17 patients.
- The overall graft patency rate was high at 93.9% (31 out of 33 anastomoses).
- No early mortality was observed, and all patients remained angina-free postoperatively.
Conclusions:
- Sequential RGEA grafting is a feasible and effective technique for achieving multiple arterial bypasses in coronary artery surgery.
- The high patency rate and excellent clinical results support the use of sequential RGEA grafting for complex CABG.
- RGEA serves as a valuable arterial conduit for in situ sequential bypass grafting, enhancing treatment options for coronary artery disease.
Abstract:
Between January 1989 and March 1993, sequential coronary artery bypass grafting using the right gastroepiploic artery (RGEA) were performed in seventeen patients. Seven patients were anastomosed from left anterior descending artery to diagonal artery. Six patients were anastomosed from right coronary artery to left circumflex artery. Two patients were anastomosed from right coronary artery to left anterior descending artery. Two patients were anastomosed to two branches of left circumflex artery and one patient was anastomosed from right coronary artery to two branches of left circumflex artery. Postoperative angiograms were performed sixteen patients and patency rate was 93.9% (31/33 anastomoses). There were no early death, and all patients were free from angina. In situ anastomoses with the most of the coronary arteries could be performed, by using sequential RGEA grafting. These results indicated that sequential RGEA grafting is useful for multiple coronary artery bypass grafting by arterial graft.