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The Journal of Thoracic and Cardiovascular Surgery, Vol 105, 615-622, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
H Suma, Y Wanibuchi, Y Terada, S Fukuda, T Takayama and S Furuta
From March 1986 to September 1991, the right gastroepiploic artery has been
used for coronary artery bypass grafting in 200 patients (171 male and 29
female patients, mean age 58 years, range 6 to 80 years. They were followed
up from 6 to 70 months with a mean of 27 months. There were 16 reoperations
and 176 patients had triple vessel or left main disease. The gastroepiploic
artery (182 in situ and 18 free grafts) was anastomosed to 11 anterior
descending, 3 diagonal, 26 circumflex, and 160 right coronary arteries. The
internal thoracic artery was concomitantly used in 192 patients. The mean
number of distal anastomoses was 2.3 with arterial grafts and 3.3 including
additional saphenous vein grafts. Postoperative angiography was performed
in 152 patients within 6 months after the operation (mean 2 months) and
after the operation second angiograms were done sequentially 1 to 5 years
(mean 2 years) after the operation in 40 patients. There were 6 early and 4
late deaths. A new Q wave was noted in 4 patients. Duration of the
operation and postoperative complications did not increase with the use of
the gastroepiploic artery. Relief of angina was noted in 186 patients.
Gastroepiploic artery graft patency was 95% (144/152) in the early
postoperative period and 95% (38/40) in the late postoperative period.
Percutaneous transluminal coronary angioplasty was done successfully
through the in situ gastroepiploic artery graft for anastomotic stenosis in
four cases. In stress myocardial scintiscans, performed sequentially
preoperatively and in the immediate, 1-year, and 2-year postoperative
periods in 11 patients, washout rate of the gastroepiploic artery-grafted
area improved from 35% +/- 10% to 45% +/- 15% (p < 0.05) and was
maintained to 43% +/- 6% and 48% +/- 9% at respective periods. In
conclusion, the gastroepiploic artery is a suitable conduit for coronary
artery bypass grafting in terms of low surgical risk, high patency rate,
and excellent patient outcome.
ARTICLES
The right gastroepiploic artery graft. Clinical and angiographic midterm results in 200 patients
Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
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G. Tavilla, J. Jackimovicz, and E. Berreklouw Intraoperative Blood Flow Measurement of the Right Gastroepiploic Artery Using Pulsed Doppler Echocardiography Ann. Thorac. Surg., August 1, 1997; 64(2): 426 - 431. [Abstract] [Full Text]
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G. Ramasubrahmanyam, G. U. Rani, and D. P. Rao Internal Thoracic Artery Pedicle Hematoma Management With Radial Artery Extension Ann. Thorac. Surg., January 1, 1997; 63(1): 304 - 304. [Full Text]
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T. Isomura, T. Sato, K. Hisatomi, N. Hayashida, and H. Maruyama Intermediate Clinical Results of Combined Gastroepiploic and Internal Thoracic Artery Bypass Ann. Thorac. Surg., December 1, 1996; 62(6): 1743 - 1747. [Abstract] [Full Text]
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N. Uchida and Y. Kawaue Flow Competition of the Right Gastroepiploic Artery Graft in Coronary Revascularization Ann. Thorac. Surg., November 1, 1996; 62(5): 1342 - 1346. [Abstract] [Full Text]
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J. G. Grandjean, A. A. Voors, P. W. Boonstra, P. d. Heyer, and T. Ebels EXCLUSIVE USE OF ARTERIAL GRAFTS IN CORONARY ARTERY BYPASS OPERATIONS FOR THREE-VESSEL DISEASE: USE OF BOTH THORACIC ARTERIES AND THE GASTROEPIPLOIC ARTERY IN 256 CONSECUTIVE PATIENTS J. Thorac. Cardiovasc. Surg., October 1, 1996; 112(4): 935 - 942. [Abstract] [Full Text]
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E. Manasse, G. Sperti, H. Suma, C. Canosa, A. Kol, L. Martinelli, R. Schiavello, F. Crea, A. Maseri, and G. F. Possati Use of the Radial Artery for Myocardial Revascularization Ann. Thorac. Surg., October 1, 1996; 62(4): 1076 - 1082. [Abstract] [Full Text]
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S. Voutilainen, K. Verkkala, A. Jarvinen, and P. Keto Angiographic 5-Year Follow-up Study of Right Gastroepiploic Artery Grafts Ann. Thorac. Surg., August 1, 1996; 62(2): 501 - 505. [Abstract] [Full Text]
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J. G. Grandjean, M. A. Mariani, and T. Ebels Coronary Reoperation via Small Laparotomy Using Right Gastroepiploic Artery Without CPB Ann. Thorac. Surg., June 1, 1996; 61(6): 1853 - 1855. [Abstract] [Full Text]
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H. Satoh, Y. Miyamoto, M. Koyama, and H. Matsuda Internal Thoracic Artery Holder for Coronary Artery Bypass Grafting Ann. Thorac. Surg., April 1, 1996; 61(4): 1269 - 1270. [Full Text]
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H. Hashimoto, T. Isshiki, Y. Ikari, K. Hara, F. Saeki, T. Tamura, T. Yamaguchi, and H. Suma EFFECTS OF COMPETITIVE BLOOD FLOW ON ARTERIAL GRAFT PATENCY AND DIAMETERMEDIUM-TERM POSTOPERATIVE FOLLOW-UP J. Thorac. Cardiovasc. Surg., February 1, 1996; 111(2): 399 - 407. [Abstract] [Full Text]
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T. Carrel, F. W. Ammann, J. Schneider, H. Domeisen, and M. Turina ATHEROSCLEROTIC LESIONS OF THE GASTROEPIPLOIC ARTERY: ONE CASE REQUIRING POSTOPERATIVE DILATION AND SOME INTERESTING POSTMORTEM OBSERVATIONS J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1768 - 1770. [Full Text]
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J. Pym, P. Brown, M. Pearson, and J. Parker Right Gastroepiploic-to-Coronary Artery Bypass : The First Decade of Use Circulation, November 1, 1995; 92(9): 45 - 49. [Abstract] [Full Text]
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C. A. Dietl, C. H. Benoit, C. L. Gilbert, E. L. Woods, W. F. Pharr, M. D. Berkheimer, N. P. Madigan, and F. J. Menapace Which Is the Graft of Choice for the Right Coronary and Posterior Descending Arteries? : Comparison of the Right Internal Mammary Artery and the Right Gastroepiploic Artery Circulation, November 1, 1995; 92(9): 92 - 97. [Abstract] [Full Text]
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P. A. Spence, W. D. Montgomery, and W. P. Santamore HIGH FLOW DEMAND ON SMALL ARTERIAL CORONARY BYPASS CONDUITS PROMOTES GRAFT SPASM J. Thorac. Cardiovasc. Surg., October 1, 1995; 110(4): 952 - 962. [Abstract] [Full Text]
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H. Suma, I. Kigawa, T. Horii, J.-i. Tanaka, S. Fukuda, and Y. Wanibuchi Coronary Artery Reoperation Through the Left Thoracotomy With Hypothermic Circulatory Arrest Ann. Thorac. Surg., October 1, 1995; 60(4): 1063 - 1066. [Abstract] [Full Text]
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A. M. Calafiore, G. Di Giammarco, G. Teodori, E. D'Annunzio, G. Vitolla, C. Fino, and N. Maddestra Radial Artery and Inferior Epigastric Artery in Composite Grafts: Improved Midterm Angiographic Results Ann. Thorac. Surg., September 1, 1995; 60(3): 517 - 523. [Abstract] [Full Text]
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C. A. Dietl, J. E. Deitrick, J. C. West, and T. J. Pagana Laparotomy After Using the Gastroepiploic Artery Graft: Retrogastric Versus Antegastric Route Ann. Thorac. Surg., August 1, 1995; 60(2): 382 - 385. [Abstract] [Full Text]
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M. A. Verhofste and S. K. C. Tam Diaphragmatic Hernia After Right Gastroepiploic Artery Coronary Artery Bypass Grafting Ann. Thorac. Surg., August 1, 1995; 60(2): 458 - 459. [Abstract] [Full Text]
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C. A. Dietl and C. H. Benoit Radial Artery Graft for Coronary Revascularization: Technical Considerations Ann. Thorac. Surg., July 1, 1995; 60(1): 102 - 109. [Abstract] [Full Text]
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O. Jegaden, A. Eker, P. Montagna, J. Ossette, G. De Gevigney, G. Finet, A. S. Pierre, D. Revel, R. Itti, and P. H. Mikaeloff Risk and Results of Bypass Grafting Using Bilateral Internal Mammary and Right Gastroepiploic Arteries Ann. Thorac. Surg., April 1, 1995; 59(4): 955 - 960. [Abstract] [Full Text]
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G.-W. He and C.-Q. Yang Comparison among arterial grafts and coronary artery: An attempt at functional classification J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 707 - 715. [Abstract] [Full Text]
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Y. Terada and T. Mitsui A communication between the gastroepiploic artery and vein in the pedicle J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 588 - 589. [Full Text]
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H. Yokoyama and S. Tanaka Simple Arterial Graft Holder for Coronary Artery Bypass Grafting Ann. Thorac. Surg., February 1, 1995; 59(2): 533 - 534. [Abstract] [Full Text]
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L. C. H. John, C. L. H. Chan, and D. R. Anderson Potential Use of the Intercostal Artery as an In Situ Graft: A Cadaveric Study Ann. Thorac. Surg., January 1, 1995; 59(1): 190 - 194. [Abstract] [Full Text]
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H. Nishida, M. Endo, H. Koyanagi, T. Koyanagi, and K. Nakamura Coronary artery bypass grafting with the right gastroepiploic artery and evaluation of flow with transcutaneous Doppler echocardiography J. Thorac. Cardiovasc. Surg., September 1, 1994; 108(3): 532 - 539. [Abstract] [Full Text]
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T. Isomura, K. Hisatomi, A. Hirano, K. Ohishi, O. Inoue, and H. Kato The right gastroepiploic artery and its growth potential J. Thorac. Cardiovasc. Surg., September 1, 1994; 108(3): 592 - 593. [Full Text]
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M. Pasic, T. Carrel, L. Von Segesser, and M. Turina Postoperative diaphragmatic hernia after use of the right gastroepiploic artery for coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., July 1, 1994; 108(1): 189 - 191. [Full Text]
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F. L. Caes, B. Francois, and G. J. Van Nooten Transdiaphragmatic herniation of the stomach after right gastroepiploic artery grafting J. Thorac. Cardiovasc. Surg., July 1, 1994; 108(1): 191 - 193. [Full Text]
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B. W. Lytle, D. McElroy, P. McCarthy, F. D. Loop, P. C. Taylor, M. Goormastic, R. W. Stewart, and D. M. Cosgrove Influence of arterial coronary bypass grafts on the mortality in coronary reoperations J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 675 - 683. [Abstract] [Full Text]
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