HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cremer, J. Articles by Haverich, A. Search for Related Content PubMed PubMed Citation Articles by Cremer, J. Articles by Haverich, A.

European Journal of Cardio-Thoracic Surgery, Vol 7, 423-427, Copyright © 1993 by European Association for Cardio-thoracic Surgery

ARTICLES

The inferior epigastric artery for coronary bypass grafting. Functional assessment and clinical results

J Cremer, A Mugge, M Schulze, HJ Trappe, M Schneider, B Heublein and A Haverich
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany.

The use of the internal thoracic artery (ITA) for coronary bypass grafting (CBG) has resulted in superior long-term function. Other autologous arteries have been investigated also, but the role of the inferior epigastric artery (IEA) for CBG has not yet been defined. From March 91 to August 92, IEA grafts were used in 50 male patients aged 30- 68 years/mean 54.9) combined with 1 (n = 40) or 2 (n = 8) ITA grafts. Pedicled grafts were dissected (length: 8.5-16.5, 13.1 cm) but left in situ covered by sponges soaked with papaverine solution until going on bypass. There was no mechanical or pharmacological intraluminal manipulation. Distal free flow (in situ) was 41.8 ml/min (16-95 ml/min). A total of 146 grafts were constructed (2.9/patient), including free IEA-CBG performed to the LAD (n = 28) or its diagonal branches (n = 22). The operative mortality was 2.0%, there were no sternal wound complications but superficial abdominal infections in 5 patients. Recatheterization (1-6 months postoperatively) revealed an 82.6% patency rate (19/23) in IEA, compared to 100% in ITA, grafts. In vitro stimulation of arterial segments by endothelium- or muscular- dependent relaxation revealed a response (% of the maximum) of 92.4% in IEA and 74.6% in ITA to acethylcholine, while the response to nitroglycerin was 92.7% and 98.6%, respectively. Our clinical results would support the concept of combining IEA and ITA for arterial revascularization in CBG. Inferior epigastric artery grafts should provide adequate blood flow and good long-term patency due to preservation of their endothelial function.

This article has been cited by other articles:

				N. J.G.M. Veeger, G. F. Panday, A. A. Voors, J. G. Grandjean, J. van der Meer, and P. W. Boonstra Excellent Long-Term Clinical Outcome After Coronary Artery Bypass Surgery Using Three Pedicled Arterial Grafts in Patients With Three-Vessel Disease Ann. Thorac. Surg., February 1, 2008; 85(2): 508 - 512. [Abstract] [Full Text] [PDF]

				E. Gongora and T. M. Sundt III Myocardial Revascularization with Cardiopulmonary Bypass Card. Surg. Adult, January 1, 2008; 3(2008): 599 - 632. [Full Text]

				G. Teodori, P.-P. Caimmi, T. Toscano, and M. Bernardi Use of the inferior epigastric artery for CABG MMCTS, March 15, 2006; 2006(0315): 794. [Abstract] [Full Text] [PDF]

				Y. J. Woo and T. J. Gardner Myocardial Revascularization with Cardiopulmonary Bypass Card. Surg. Adult, January 1, 2003; 2(2003): 581 - 607. [Full Text]

				M. Barton and B. Glodny Endothelin receptor blockade and nitric oxide bioactivity: [Cardiovascular Research 2001;49:146-151] Cardiovasc Res, October 1, 2001; 52(1): 161 - 163. [Full Text] [PDF]

				M. Buche and E. Schroeder Runoff dependence of inferior epigastric artery grafts in coronary artery operations J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1567 - 1568. [Full Text]