Coronary artery bypass surgery utilizing right gastroepiploic artery.
Fifteen patients (10 men, 5 women), who underwent coronary artery bypass surgery utilizing the right gastroepiploic artery (R't GEAR) in combination with either the left internal mammary artery (LIMA) or the greater saphenous vein as graft material, were studied. The reasons for utilizing R't GEAR were previous coronary artery bypass operations with resulting marked wound adhesion prohibiting LIMA harvest (five cases), LIMA jeopardized during surgery (three cases), total arterial revascularization using LIMA + R't GEAR (four cases), and near total arterial revascularization using LIMA + R't GEAR + saphenous veins (SV) (three cases). A total of 40 coronary arteries were revascularized: the R't GEAR was used for revascularization of 11 left anterior descending arteries, three right coronary arteries, and one left circumflex artery; LIMA was used for revascularization of four left anterior descending arteries, and three diagonal arteries; the saphenous vein was used for revascularization of eight left circumflex arteries, three diagonal arteries, six posterior descending arteries, and one proximal right coronary artery. There were no hospital mortalities, and follow-up studies revealed satisfactory early results. From our preliminary experience with these 15 cases, we assume that the R't GEAR can be used as the graft material of choice for coronary artery bypass in cases where difficulty in LIMA utilization is encountered or insufficient vein graft conduit is available. It is particularly valuable in reoperations for coronary arterial disease.
Department of Thoracic and Cardiovascular Surgery, Cathay General Hospital, Taipei, Taiwan, R.O.C.
T H
TH
Chen
D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000098:blood supply; D013270:Stomach / Q000098:blood supply*