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Inferior epigastric artery for myocardial revascularization

H B Barner1, K S Naunheim, P S Peigh

  • 1Department of Surgery, St. Louis University Medical Center, MO 63110-0250.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 1, 1993
PubMed
Summary

The inferior epigastric artery (IEA) is a viable option for myocardial revascularization, offering similar flow to the internal thoracic artery (ITA). Further studies are needed to confirm its long-term effectiveness.

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Grafting

Background:

  • Myocardial revascularization commonly utilizes arterial grafts.
  • The internal thoracic artery (ITA) is a preferred conduit.
  • Alternative arterial conduits are being investigated to expand revascularization options.

Purpose of the Study:

  • To evaluate the safety and efficacy of the inferior epigastric artery (IEA) as an additional arterial conduit for myocardial revascularization.
  • To compare the characteristics of the IEA with the ITA in terms of harvest time, length, and flow.

Main Methods:

  • Prospective study of 108 patients undergoing myocardial revascularization between March 1990 and January 1992.
  • Utilized inferior epigastric arteries (IEA) in 108 patients and internal thoracic arteries (ITA) in 87 patients.

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  • Analyzed operative mortality, complications, and graft characteristics.

    • Main Results:

    • The IEA demonstrated a longer harvest time (36.5 min vs 29.6 min) and shorter usable length (11.9 cm vs 16.5 cm) compared to the ITA.
    • Flow rates between the IEA (49.7 cc/min) and ITA (48.7 cc/min) were similar.
    • Operative mortality was 2.8%, with respiratory insufficiency being the most common major complication (12%).

    Conclusions:

    • The inferior epigastric artery (IEA) is an acceptable arterial conduit for myocardial revascularization.
    • The IEA can be safely used in conjunction with one or both internal thoracic arteries (ITA).
    • Long-term patency data is required to establish preferential use of the IEA.