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Gastroepiploic artery graft in 400 patients
1Department of Cardiovascular Surgery, Mitsui Memorial Hospital I, Tokyo, Japan.
Insights
The right gastroepiploic artery (GEA) is a safe and effective arterial conduit for coronary artery bypass grafting (CABG). Studies show high graft patency rates and low mortality, making GEA a valuable option for revascularization.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease.
- Arterial grafts are preferred over venous grafts due to better long-term patency.
- The right gastroepiploic artery (GEA) has emerged as a viable arterial conduit.
Purpose of the Study:
- To evaluate the safety and efficacy of the right gastroepiploic artery (GEA) as an arterial conduit for coronary artery bypass grafting (CABG).
Main Methods:
- Retrospective analysis of 400 patients undergoing CABG using GEA over an 8-year period.
- Concomitant use of internal thoracic artery (ITA) and inferior epigastric artery grafts was noted.
- Graft patency assessed via postoperative angiography at 2 months and 2-5 years.
Main Results:
- GEA was used in 400 of 1359 CABG patients (29.4%).
- Early and late mortality rates were low (2% and 1.3%, respectively).
- Graft patency was high: 94% early and 94% late.
Conclusions:
- The right gastroepiploic artery (GEA) is a safe and effective arterial conduit for CABG.
- GEA demonstrates excellent long-term patency and contributes to favorable patient outcomes.
- Its use is associated with a low incidence of complications and mortality.
Abstract:
The right gastroepoploic artery (GEA) has been used for coronary artery bypass grafting (CABG) in 400 patients of a total of 1359 undergoing the same procedure during an 8-year period. There were 327 males and 73 females with a mean age of 59 years. Single-, double- and triple-vessel and left main disease were noted in 4, 51, 283 and 62 patients, respectively. Previous myocardial infarction was noted in 208 patients and 40 patients had undergone previous CABG. Internal thoracic artery (ITA) and inferior epigastric artery grafts were concomitantly used in 388 (97%) and 30 (8%) patients, respectively. The mean number of grafts was 3.2 including vein grafts, and 2.3 coronary arteries were bypassed with arterial grafts. The sites of GEA grafting were 43 anterior descending, 6 diagonal, 71 circumflex, and 287 right coronary arteries with 376 in situ and 24 free grafts including 7 sequential grafts. There were eight (2%) early and five (1.3%) late deaths. New Q waves were noted in six (1.5%) patients. Warm body circulation is thought to be favorable with a lower incidence of the need for intra-aortic balloon pump (0.6% vs 6.0%). Postoperative angiography revealed 94% (253/268) early (2 months) and 94% (47/50) late (2-5 years) patency of GEA grafts. In conclusion. GEA is a safe and effective arterial conduit for CABG.