title: Twenty years experience with the gastroepiploic artery graft for CABG.
abstract: BACKGROUND
  To improve the longterm outcome after CABG, several strategies have been used using arterial conduits. Our 20 years experience with the right gastroepiploic artery (GEA) graft was evaluated.
  
  
  RESULTS
  In 1352 patients having CABG with the GEA graft, (1092 men, mean 63 years, 99% multivessel disease, and mean EF 0.51), internal thoracic artery, saphenous vein, and radial artery grafts were concomitantly used in 1312 (97%), 783 (58%), and 128 (8%) patients, respectively. The mean number of distal anastomoses was 3.1, and 2.4 coronary arteries were bypassed with arterial grafts. The sites for GEA grafting were 70 anterior descending, 268 circumflex, and 1089 right coronary arteries. The operative mortality was 1.26%. In 1118 follow-up patients (82.6%), 5, 10, and 15 years survival rates were 91.7%, 81.4%, and 71.3%, and the cardiac death-free survival rates were 95.8%, 91.7%, and 88.6%, respectively. The cumulative patency rate of the GEA graft was 97.1% at 1 month, 92.3% at 1 year, 85.5% at 5 years, and 66.5% at 10 years, respectively. In 172 skeletonized GEA grafts with 233 distal anastomoses, the patency rate at immediate, 1, and 4 years after surgery was 97.6%, 92.9%, and 86.4%, respectively. In 124 patients with late (5 to 17 years) restudy, patency rate was 96% (114/119) in the left internal thoracic artery, 87% (108/124) in GEA, and 68% (67/98) in saphenous vein grafts. New stenosis was uncommon in GEA.
  
  
  CONCLUSIONS
  The GEA graft is a safe and effective arterial conduit for CABG.
authors.affiliation: The Cardiovascular Institute, 7-3-10 Roppongi, Minato-Ku, Tokyo 106-0032, Japan. suma@cvi.or.jp
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Suma
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanabe
authors.forename: Akihito
authors.initials: A
authors.lastname: Takahashi
authors.forename: Taiko
authors.initials: T
authors.lastname: Horii
authors.forename: Tadashi
authors.initials: T
authors.lastname: Isomura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirose
authors.forename: Atsushi
authors.initials: A
authors.lastname: Amano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D001026:Coronary Artery Bypass / Q000379:methods / Q000639:trends*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D024405:Gastroepiploic Artery / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016378:Tissue Transplantation / Q000639:trends; D019737:Transplants / Q000639:trends*; D016896:Treatment Outcome