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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 256-259, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
J Pym, PM Brown, EJ Charrette, JO Parker and RO West
Although increasing use is being made of arterial grafts (the internal
mammary arteries) for direct myocardial revascularization, it is frequently
not possible to reach the posterior surface of the heart with the internal
mammary as either a pedicle or a free graft. Since June 1984 we have used
the right gastroepiploic artery in nine patients as a pedicle graft to the
distal right coronary artery (four patients), the posterior descending
artery (three patients), and the distal circumflex branches (two patients).
Eight patients survived the operation. Celiac axis opacification confirmed
patency in six and coronary angiography strongly suggested patency in the
remaining two. All survivors are functionally in New York Heart Association
Class I or II. The early angiographic and clinical results demonstrate the
feasibility of using the right gastroepiploic artery as a bypass graft to
coronary vessels on the posterior surface of the heart when traditional
conduits are unsuitable. If its long-term patency as a living arterial
graft is similar to that of the internal mammary arteries, the
gastroepiploic artery may become the coronary bypass graft of choice for
the distal right coronary and circumflex systems.
ARTICLES
Gastroepiploic-coronary anastomosis. A viable alternative bypass graft
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