Right gastroepiploic artery graft: long-term clinical follow-up in 271 patients--experience of a single center.
OBJECTIVE
We present our experience in the use of right gastroepiploic artery (rGEA). Long-term clinical results are reported.


METHODS
From April 1994 to June 2005, 271 patients (257 males, mean age 56.2 +/- 7.1) underwent coronary artery bypass grafting with the use of rGEA. Preoperative, perioperative, and postoperative data were retrospectively collected and clinical results and survival were examined. The end points of follow-up were death and recurrence of cardiac events such as angina and myocardial infarction (MI). The mean follow-up was 8.2 +/- 2.9 years.


RESULTS
Left ventricular ejection fraction ranged from 0.20 to 0.68 (mean 0.55 +/- 0.7). The mean cardiopulmonary bypass time was 96.8 +/- 15.8 minutes and the mean cross-clamping time was 69.7 +/- 14.2 minutes. The mean number of distal anastomosis was 3.3 +/- 0.7 (range 2 to 5). Early mortality was 2.6% and postoperative MI occurred in three patients. There were 21 (7.9%) late deaths and three of them (1.2%) were cardiac related. Actuarial 10-year-survival of all deaths, including in-hospital death, was 70.8%+/- 9.9%. No abdominal complications occurred during or after rGEA harvesting. Seven patients have been suffering of recurrence of angina. Angiography was performed only on those patients with recurrent angina.


CONCLUSIONS
The rGEA can be considered as a valid arterial conduit, relatively easy to harvest, safe to use with low perioperative risks, and good mid- and long-term results. The low early and late rate mortality and the satisfactory clinical results are good reasons for using routinely this conduit in selected patients.
Formica
Francesco
F
Cardiac Surgery Clinic, Surgical Science, and Intensive Care Department, University of Milan-Bicocca, San Gerardo Hospital, Via Pergolesi 33, 20052 Monza, Italy. francesco.formica@fastwebnet.it
Greco
Pierpaolo
P
Colagrande
Luisa
L
Martino
Antonello
A
Corti
Fabrizio
F
Ferro
Orazio
O
Paolini
Giovanni
G
D000328:Adult; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D024405:Gastroepiploic Artery / Q000637:transplantation*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply*; D014654:Vascular Patency