title: Sequential bypass using the right gastroepiploic artery for coronary artery bypass grafting.
abstract: OBJECTIVE
  Since 1989, we have applied the right gastroepiploic artery (RGEA) as a third arterial conduit for coronary artery bypass grafting (CABG) and started to use sequential RGEA in 1992. We evaluated the feasibility and efficacy of sequential RGEA grafting in CABG.
  
  
  METHODS
  From December 1990 to January 2000, 46 patients underwent CABG with sequential RGEA. There were 42 male and 4 female patients with a mean age of 59 +/- 8.1 years. Mean postoperative follow-up period was 70 months.
  
  
  RESULTS
  The mean number of anastomoses was 3.7 per patient. Mean luminal diameter of the RGEA was 2.2 +/- 0.4 mm by preoperative angiography and 2.3 +/- 0.6 mm by intraoperative measurement. Patency of the sequential RGEA was 92%; proximal anastomosis 100%, distal anastomosis 86% (p = 0.01). The 5-year actuarial survival and cardiac event-free rate were 91% and 93%, respectively.
  
  
  CONCLUSIONS
  Sequential bypass using the RGEA is feasible, with excellent early and long-term results. The indication for sequential RGEA, however, needs careful anatomical consideration of both the luminal diameter of the RGEA and proximal stenosis of the target coronary arteries.
authors.affiliation: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishida
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kurosawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishida
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Aomi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Endo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D024405:Gastroepiploic Artery / Q000503:physiopathology / Q000637:transplantation*; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology