[Mid-term results in coronary revascularization using the right gastroepiploic artery graft].
We studied the mid-term results in 191 patients (including emergent operation in 27 patients) who have performed coronary artery bypass grafting (CABG) using the right gastroepiploic artery (REGA) for 74 months (mean follow up period was 37 months). We evaluated the postoperative results in terms of 1. mortality and survival rate, 2. graft angiography, 3. cardiac event free rate and 4. abdominal complications. We had operative death in 6 patients (3.1%) including 3 patients of emergent operations. Late deaths were found in 11 patients (5.9%): 2 patients were cardiac death and 9 were non-cardiac. The actual survival rates were 94.2% at one year, 90.0% at three years and 85.9% at five years. Early patency rate of the RGEA was 98.9% (n = 178). However flow competition between the RGEA and native coronary artery was seen in 42 patients (24.0%). Mid-term patency rate was 96.4% (n = 28). According to mid-term graft angiography, 1 patient improved and 5 patients got worse in comparison with early control. Cardiac event free rates were 98.2% at 1 year, 94.8% at 3 years and 92.7% at 5 years. Abdominal complications were observed in 5 patients (1 patient of bleeding from the RGEA, 1 of gastric perforation, 2 of bleeding from gastric ulcer and 1 of pyloric stenosis) at early period and in 7 patients (2 patients of incisional hernia and 5 of gastric cancer) at long-term period. Early and mid-term results of CABG using the RGEA were quite good. However, the RGEA had a tendency of flow competition against native coronary artery and a problem of gastric cancer after the operation.
Uchida
N
N
Department of Cardiovascular Surgery, Hiroshima General Hospital, Japan.
Kawaue
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000002:abnormalities*; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000098:blood supply*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013270:Stomach / Q000098:blood supply*; D013274:Stomach Neoplasms / Q000209:etiology / Q000517:prevention & control; D015996:Survival Rate; D014654:Vascular Patency