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

This Article Full Text 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 Author home page(s): Hiroyuki Kamiya Go Watanabe Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kamiya, H. Articles by Kanamori, T. Search for Related Content PubMed PubMed Citation Articles by Kamiya, H. Articles by Kanamori, T. Related Collections Minimally invasive surgery

J Thorac Cardiovasc Surg 2004;127:1151-1157
© 2004 The American Association for Thoracic Surgery

Surgery for acquired cardiovascular disease

Total arterial revascularization with composite skeletonized gastroepiploic artery graft in off-pump coronary artery bypass grafting

^a Department of General and Cardiothoracic Surgery, Kanazawa University Hospital, Kanazawa, Japan

Received for publication July 17, 2003; revisions received September 23, 2003; revisions received September 30, 2003; accepted for publication November 20, 2003.

^* Address for reprints: Hiroyuki Kamiya, MD, Department of General and Cardiothoracic Surgery, Kanazawa University Hospital, Takaramachi 13-1, Kanazawa, Japan 920-8641
hkamiya88{at}yahoo.co.jp

BACKGROUND: Total arterial revascularization in coronary artery bypass grafting has recently become of great interest to many surgeons. At the same time, off-pump coronary bypass grafting has also become a popular procedure because of its low morbidity and mortality. Here we report our recent series of off-pump coronary bypass grafting performed with a grafting technique we developed by using the skeletonized gastroepiploic artery and the radial artery composite graft to achieve total arterial revascularization.

METHODS: From September 2000 to April 2003, 98 patients underwent total arterial revascularization with the skeletonized gastroepiploic artery and radial artery composite graft on the beating heart. We used the gastroepiploic artery graft of choice in patients with a right coronary artery lesion. When multiple grafting was required in inferior, posterolateral, or lateral ventricular walls and the gastroepiploic artery graft was too short to cover these areas, we used the composite grafting technique.

RESULTS: There were no in-hospital deaths and there was no severe morbidity among the study patients. Postoperative angiography showed graft occlusion at the anastomosis site between the gastroepiploic and radial arteries. The patency rate of the gastroepiploic arterial composite graft was 98.3% (118/120 distal anastomoses).

CONCLUSIONS: A composite graft with the skeletonized gastroepiploic artery and the radial artery ensured sufficient caliber size and length for myocardial revascularization on inferior, posterolateral, and lateral ventricular walls. This composite graft can be used safely and effectively even in off-pump coronary bypass surgery with excellent early clinical and angiographic outcome in selected patients, although longer follow-up periods are necessary to draw definitive conclusions.

This article has been cited by other articles:

				Y. Shimamura and I. Hayashi Graft fixation with a side graft holder for sequential and composite graft anastomosis in coronary artery bypass surgery Interactive CardioVascular and Thoracic Surgery, December 1, 2009; 9(6): 939 - 942. [Abstract] [Full Text] [PDF]

				M. Shrestha, N. Khaladj, H. Kamiya, M. Maringka, A. Haverich, and C. Hagl Total Arterial Revascularization and Concomitant Aortic Valve Replacement Asian Cardiovasc Thorac Ann, October 1, 2007; 15(5): 381 - 385. [Abstract] [Full Text] [PDF]

				H. Suma, H. Tanabe, A. Takahashi, T. Horii, T. Isomura, H. Hirose, and A. Amano Twenty Years Experience With the Gastroepiploic Artery Graft for CABG Circulation, September 11, 2007; 116(11_suppl): I-188 - I-191. [Abstract] [Full Text] [PDF]

				P. G. Malvindi, S. Jacob, A. Kallikourdis, and N. Vitale What is the patency of the gastroepiploic artery when used for coronary artery bypass grafting? Interactive CardioVascular and Thoracic Surgery, June 1, 2007; 6(3): 397 - 402. [Abstract] [Full Text] [PDF]

				K.-B. Kim, K. R. Cho, J.-S. Choi, and H.-J. Lee Right Gastroepiploic Artery for Revascularization of the Right Coronary Territory in Off-Pump Total Arterial Revascularization: Strategies to Improve Patency Ann. Thorac. Surg., June 1, 2006; 81(6): 2135 - 2141. [Abstract] [Full Text] [PDF]

				T. Fukui, S. Takanashi, Y. Hosoda, and S. Suehiro Total Arterial Myocardial Revascularization Using Composite and Sequential Grafting With the Off-Pump Technique Ann. Thorac. Surg., August 1, 2005; 80(2): 579 - 585. [Abstract] [Full Text] [PDF]

				L. R. Sajja, G. Mannam, N. R. Pantula, and S. Sompalli Role of Radial Artery Graft in Coronary Artery Bypass Grafting Ann. Thorac. Surg., June 1, 2005; 79(6): 2180 - 2188. [Abstract] [Full Text] [PDF]