title: Transplantation of the free gastroepiploic artery graft for myocardial revascularization: long-term clinical and angiographic results.
abstract: BACKGROUND
  Use of the free gastroepiploic artery (GEA) graft for coronary revascularization is not very popular because of its tendency to vasospasm. We hypothesize that the cause of free GEA spasm is graft damage caused by an interruption of venous drainage from the graft. To overcome this problem, we anastomosed the accompanied gastroepiploic vein to the right atrial appendage simultaneously with the GEA grafting in the aortocoronary position. We here assess the clinical result and the angiographic patency of the free GEA graft in our method in the late postoperative period.
  
  
  METHODS
  Between January 1997 and April 2001, 57 patients underwent coronary artery grafting with a free GEA using our method. A total of 169 distal anastomoses (average 2.96) were constructed. The free GEA grafts were anastomosed to the main right coronary artery in 26 patients, right coronary artery branch in 27, left anterior descending artery in 1 patient, high lateral branch in 2 patients, and circumflex branch in 2. The mean clinical follow-up is 77 months (range, 35 to 110) in 57 cases, and the angiographic follow-up averages 77 months (range, 37 to 110) in 46 cases.
  
  
  RESULTS
  There was no cardiac death, and all patients were in Canadian Cardiovascular Society class II or less. The mean 77-month patency rate of the free GEA in our method was 95.7%. The patency rates of internal thoracic artery, radial artery, and saphenous vein graft in the same period were respectively 93.2%, 100%, and 81.3%.
  
  
  CONCLUSIONS
  Free GEA grafting with venous drainage for myocardial revascularization provided excellent long-term performance.
authors.affiliation: Department of Cardiovascular Surgery, Aichi Cardiovascular and Respiratory Center, Aichi, Japan. cdb57810@hkg.odn.ne.jp
authors.forename: Tadahito
authors.initials: T
authors.lastname: Eda
authors.forename: Akio
authors.initials: A
authors.lastname: Matsuura
authors.forename: Ken
authors.initials: K
authors.lastname: Miyahara
authors.forename: Haruki
authors.initials: H
authors.lastname: Takemura
authors.forename: Sadanari
authors.initials: S
authors.lastname: Sawaki
authors.forename: Teruaki
authors.initials: T
authors.lastname: Yoshioka
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D000368:Aged; D024405:Gastroepiploic Artery / Q000000981:diagnostic imaging* / Q000502:physiology / Q000637:transplantation*; D006801:Humans; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D014654:Vascular Patency