Skeletonized gastroepiploic artery as a composite graft for total arterial revascularization.
BACKGROUND
Despite the purported advantages of using a gastroepiploic artery graft during coronary artery bypass, insufficient potential flow capacity and vasospasm remain major concerns. We assessed the efficacy and results of using a skeletonized composite gastroepiploic artery graft in situations in which bilateral internal thoracic and radial arteries could not be used.


METHODS
Between January 2000 and August 2002, 37 patients (25 men, 12 women; mean age, 59.9 years) underwent grafting with composite grafts using a skeletonized left internal thoracic artery plus the gastroepiploic artery. Coronary angiograms were performed in the immediate (median, 14 days, 36 patients) and early (median, 348 days, 32 patients) postoperative periods. Off-pump coronary artery bypass grafting was performed in all but 2 patients.


RESULTS
There were no deaths. The respective postoperative patencies of the left internal thoracic artery and gastroepiploic artery were 36 of 37 (97.2%) and 73 of 75 (97.3%) at the immediate period, and 34 of 34 and 62 of 67 (92.5%) at the early period. During follow-up, only 1 patient required percutaneous intracoronary intervention for gastroepiploic artery occlusion.


CONCLUSIONS
Skeletonized composite gastroepiploic artery grafts showed satisfactory clinical and angiographic results in situations in which bilateral internal thoracic and radial arteries could not be used. Although it needs longer follow-up, these early results demonstrated that the gastroepiploic artery may be a useful option in some situations of total arterial revascularization, used either as an in situ or as a composite graft.
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Seoul, South Korea.
Sang-Wan
SW
Ryu
Byoung-Hee
BH
Ahn
Suk-Jung
SJ
Choo
Kook-Ju
KJ
Na
Young-Keun
YK
Ahn
Myung-Ho
MH
Jeong
Sang-Hyung
SH
Kim
D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D001026:Coronary Artery Bypass / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D024405:Gastroepiploic Artery / Q000637:transplantation*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged