title: Low recurrence of angina pectoris after coronary artery bypass graft surgery with bilateral internal thoracic and right gastroepiploic arteries.
abstract: BACKGROUND
  In the past 10 years, there has been a trend to use more arterial grafts instead of vein grafts for coronary artery bypass graft surgery. Although there are many reports on the short- and mid-term follow-up of patients who underwent arterial revascularization with 1 or 2 arteries, little has been reported on the follow-up of patients with 3-vessel disease who received 3 arteries.
  
  
  RESULTS
  We reviewed a group of 256 patients with 3-vessel disease who received the right gastroepiploic artery together with both internal thoracic arteries (ITAs). Vein grafts were not used in these patients. The patients were monitored for up to 7 years (mean, 51+/-15 months). Seven-year actuarial survival was 91.1%. The cumulative probability of event-free survival for myocardial infarction, reintervention, and angina pectoris at 7 years was 97.3%, 95.4%, and 85.4%, respectively.
  
  
  CONCLUSIONS
  We conclude that concomitant use of the gastroepiploic artery with both ITAs results in low mortality and a low incidence of myocardial infarction and reintervention at follow-up. Most interestingly, we found 85.4% freedom from angina pectoris after 7 years, which is considerably lower than the results of studies in which vein grafts, single ITA grafts, or double ITA grafts are used. These results strongly support the use of both ITAs and the right gastroepiploic artery for bypass grafting in patients with 3-vessel disease.
authors.affiliation: Thoraxcenter, University Hospital Groningen, The Netherlands.
authors.forename: T M
authors.initials: TM
authors.lastname: Bergsma
authors.forename: J G
authors.initials: JG
authors.lastname: Grandjean
authors.forename: A A
authors.initials: AA
authors.lastname: Voors
authors.forename: P W
authors.initials: PW
authors.lastname: Boonstra
authors.forename: P
authors.initials: P
authors.lastname: den Heyer
authors.forename: T
authors.initials: T
authors.lastname: Ebels
mesh_terms: D000787:Angina Pectoris / Q000453:epidemiology*; D001158:Arteries / Q000637:transplantation*; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D009203:Myocardial Infarction / Q000453:epidemiology; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D013270:Stomach / Q000098:blood supply; D013895:Thoracic Arteries / Q000637:transplantation