[Flow competition of right gastroepiploic artery graft in coronary artery bypass surgery].
We evaluated the competitive flow between the right gastroepiploic artery (RGEA) and native coronary artery in coronary artery bypass surgery with respect to anastomosis in a retrograde fashion and the relationship of the degree of proximal stenosis with the flow dependency. The RGEA has been used in 157 patients and was anastomosed in a retrograde fashion in 22 patients. There was no significant difference between the retrograde anastomosis and the antegrade anastomosis on revascularization to the left anterior descending coronary artery in terms of diameter (2.0 +/- 0.5, 1.68 +/- 0.2 mm), flow (21.8 +/- 13.2, 24.5 +/- 19.4 ml/min), early patency (100%, 100%) and string sign (0%, 0%). We examined angiographically the relationship between the preoperative degree of proximal stenosis and postoperative pattern of flow dependency in the right coronary artery distal to the RGEA anastomosis in 98 patients. With a proximal stenosis of 75% (n = 19), RGEA occlusion was observed in two patients (11%), native coronary-dependent flow in four (21%), balanced flow in nine (47%) and RGEA-dependent flow in four (21%). With a proximal stenosis of 90% (n = 16), native-dependent flow was observed in one (6%), balanced flow in six (38%) and RGEA-dependent flow in nine (56%) patients. With a proximal stenosis of 99%-100% (n = 63), RGEA occlusion was observed in three (5%) and RGEA-dependent flow in sixty (95%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Koyanagi
T
T
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Endo
M
M
Nishida
H
H
Kitamura
M
M
Koyanagi
H
H
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001158:Arteries / Q000637:transplantation*; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000098:blood supply*; D013270:Stomach / Q000098:blood supply*