[On the use of the gastroepiploic artery in myocardial revascularization]

Between 1985 and 1992, the gastroepiploic artery was used for coronary bypass surgery in 80 consecutive patients. Revascularisation was totally arterial in 62.5% of cases, the gastroepiploic being associated with single or double internal mammary artery grafts. The gastroepiploic graft was used to revascularise the inferior myocardial regions. The postoperative morbidity was essentially due to respiratory complications: 6 patients had objective pulmonary complications and 11 patients had relative transient postoperative hypoxia. The early gastrointestinal complications were related to ulceration (5 patients) complicated by haemorrhage in 2 patients. This morbidity was responsible for a significant increase in the period of intensive care. The hospital mortality was 6.2%, observed mainly in the first third of the author's experience and in patients with preoperative poor prognostic factors. These relatively high morbidity and mortality rates have led to a cautious use of the right gastroepiploic artery for coronary bypass surgery in patients over 70 years of age, in those with unstable angina operated as an emergency and in those with associated pathology, especially respiratory problems. The choice of a complex surgical option should not be synonimous with an increased postoperative mortality.