[The use of the right gastroepiploic artery for posterior myocardial revascularization].
From August 1992 to June 1993, eight patients underwent myocardial revascularization in whom the right gastroepiploic artery was used in order to reach the posterior myocardium. All patients were men. Ages ranged from 32 to 65 years, with a mean of 51 years. The left internal mammary artery was used in all patients. The right internal mammary artery was used in three patients and the right inferior epigastric artery was used as a free graft in one patient. There was three bypass grafts per patient with a total of 20 arterial grafts in which 19 were pediculated and one as a free graft. The aortic clamping time ranged from 52 to 80 minutes with a mean of 72 minutes. All patients received combined antegrade/retrograde cardioplegia delivery through the aortic root and the coronary sinus respectively for myocardial protection. There was no need to use inotropic support for ventricular assistance. The right gastroepiploic artery was used in order to reach the posterior myocardium and it was passed through the antero-hepatic trans-diaphragmatic route. There was no complications with the use of the right gastroepiploic artery in the early and late postoperative period. The course was excellent in all patients and they remain asymptomatic. We conclude that the use of the right gastroepiploic artery for coronary bypass grafting in order to revascularize the posterior myocardium is an excellent choice. There were no technical difficulties nor gastric complications and we are increasing our experience in order to establish its routine use.
Urrea Ramos
M S
MS
Departamento de Cirugía Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Herrera Alarcón
V
V
Santibáñez Escobar
F
F
Santibáñez Salgado
J A
JA
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000601:surgery; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*
Uso de la arteria gastroepiploica derecha para la revascularización del miocardio posterior.