European Journal of Cardio-Thoracic Surgery, Vol 5, 34-36, Copyright © 1991 by European Association for Cardio-thoracic Surgery
In situ right gastroepiploic artery. A conduit for coronary revascularization
I Gallo, A Saenz, C Alonso, I Lekuona, JI Barrenetxea, A Alonso, M Larman and JL Ubago
Cardiovascular Unit, Guipuzcoa Policlinic, San Sebastian, Spain.
The internal mammary artery is widely recognized as the graft of choice for
coronary artery bypass grafting at present. Alternative conduits have been
investigated in order to find other adequate long-term grafts. The right
gastroepiploic artery has been recently used as a graft to bypass distal
coronary vessels. From November 1989 to June 1990, we have implanted this
artery in 46 cases. Pedicled grafts were implanted in 20 patients to the
main right coronary artery, in 21 patients we grafted the right distal
branches, in 3 patients the left anterior descending, and in 2 the
circumflex branches. Mean grafts per patient were 3 in this series, with a
mean of 2.2 arterial grafts per patient. One patient died in the early
postoperative period. The remaining patients had an uncomplicated
postoperative evolution. Thirteen patients underwent graft and coronary
angiography. Direct or indirect graft patency was confirmed in all cases.
The final important issue concerning the long-term patency of this graft
will be solved in the future, but short-term patency rates of the right
gastroepiploic artery can be anticipated when proper techniques are used.