title: Theoretical analysis of right gastroepiploic artery grafting to right coronary artery.
abstract: BACKGROUND
  The right gastroepiploic artery (GEA) has been used as the second reliable arterial graft for coronary artery bypass grafting (CABG). However, concern regarding the flow competition with the recipient coronary artery has remained.
  
  
  METHODS
  An application of in situ GEA grafting to the right coronary artery (RCA) was studied by using a theoretical model. The theoretical model of CABG was given variables; ie, the diameters and the lengths of both in situ GEA and proximal segment of the RCA, and the degree of proximal stenosis in the RCA. According to the range of these variables obtained from clinical data, the ratio of the GEA flow to the flow of the RCA distal to the anastomosis was calculated.
  
  
  RESULTS
  Main factors to determine the flows in the two parallel paths were the inner diameters of both vessels, and the degree of the proximal stenosis. When the inner diameters of the GEA were 0.5 mm larger than that of the RCA, the GEA carried more than 50% of the total flow of the RCA distal to the anastomosis despite a moderate stenosis in the RCA. When the inner diameter of the GEA was equal to, or 0.5 mm smaller than, that of the RCA, the GEA flow was dominated by the native RCA flow unless the proximal stenosis was critical.
  
  
  CONCLUSIONS
  If the inner diameter of the GEA is 0.5 mm larger than that of the RCA, CABG with the GEA can be applied more widely. If not, the application would basically be limited.
authors.affiliation: Department of Thoracic Surgery, Nagoya University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yasuura
authors.forename: Y
authors.initials: Y
authors.lastname: Takagi
authors.forename: Y
authors.initials: Y
authors.lastname: Ohara
authors.forename: Y
authors.initials: Y
authors.lastname: Takami
authors.forename: A
authors.initials: A
authors.lastname: Matsuura
authors.forename: H
authors.initials: H
authors.lastname: Okamoto
mesh_terms: D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D014654:Vascular Patency