[Study of coronary bypass using right gastroepiploic artery in diabetes-complicated cases]

We have conducted coronary bypass (CABG) using right gastroepiploic artery (RGEA) in 65 patients for a period of 2 years, from December 1989 to December 1991. The patients were divided into two groups; non-diabetics (group 1 or non-DM group, 42 cases including 2 borderline cases) and diabetics (group II or DM group, 23 cases comprised of 6 cases with alimentary therapy, 10 cases with oral diabetic drug therapy, and 7 cases with insulin therapy). The clinical results of both groups at a time closely proceeding surgery were studied. No apparent difference was recognized between DM and non-DM groups, which indicated that both groups were indications for CABG. Taking precautions for the prevention of postoperative infection at the surgical wound was necessary in the DM group. The 2 cases of group II which showed beads-like constrictions on angiography at weeks 4 to 8 after surgery were assumed to remain significantly problematical in terms of the degenerative degree and patency rate of the graft after a long postoperative period. Moreover, it was possible to anastomose the graft at the site proximal to the constricted site in 1 case of group II which presented a 50% constriction at the middle region of the great curvatura ventriculi by preoperative angiography. These results suggest that in selecting the use of a RGEA graft, preoperative RGEA-angiography is necessary, particularly, in the DM group.