Limited flow capacity of the right gastroepiploic artery graft: postoperative echocardiographic and angiographic evaluation.
BACKGROUND
The flow capacity of the right gastroepiploic artery graft has not been clarified.


METHODS
Angiographic and echocardiographic studies were conducted in 30 patients who had undergone coronary artery bypass grafting using both the internal thoracic and right gastroepiploic arteries. The luminal diameter of the arterial grafts was measured from the postoperative angiograms. The adequacy of the myocardial blood supply from the arterial grafts was evaluated by dobutamine stress echocardiography.


RESULTS
With echocardiography, 14 patients exhibited an ischemic response in the gastroepiploic artery grafted region, whereas no patients exhibited an ischemic response in the internal thoracic artery grafted area. The luminal diameter of the gastroepiploic artery and a younger age were correlated with the ischemic response observed in the dobutamine stress echocardiography. A luminal diameter of the gastroepiploic artery of greater than 2.6 mm had the highest sensitivity and specificity for a nonischemic change.


CONCLUSIONS
To generate the maximal flow reserve, the luminal diameter of the gastroepiploic artery when used as a graft should be sufficiently large enough, nearly 3 mm at the anastomosis.
Ochi
M
M
Department of Surgery II, Nippon Medical School, Tokyo, Japan. ochi/surg2@nms.ac.jp
Hatori
N
N
Fujii
M
M
Saji
Y
Y
Tanaka
S
S
Honma
H
H
D000368:Aged; D000792:Angiography / Q000379:methods*; D001783:Blood Flow Velocity; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006085:Graft Survival; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D011379:Prognosis; D012680:Sensitivity and Specificity; D013270:Stomach / Q000098:blood supply*; D013895:Thoracic Arteries / Q000637:transplantation*; D014654:Vascular Patency
D004280:Dobutamine