Angiographic 5-year follow-up study of right gastroepiploic artery grafts

Ann Thorac Surg. 1996 Aug;62(2):501-5.

Abstract

Background: The right gastroepiploic artery (RGEA) has been used from 1987 in coronary artery bypass grafting in several clinical studies. However, the published 1- to 5-year patency rates have been dependent on the selection of patients for angiography.

Methods: In our study, the RGEA was used from March 1987 to May 1990 for coronary artery bypass grafting in 31 consecutive patients, 25 male and 6 female. All but 1 patient had triple-vessel disease, and the mean number of distal anastomoses was 3.9 (range, 2 to 5). Internal thoracic artery grafts were used concomitantly in all patients.

Results: One early and two late deaths occurred. All but 1 of the 28 surviving patients underwent clinical and angiographic follow-up examinations 3 months and 5 years after the operation. The 5-year patency of RGEA grafts was 82.1%, with a 95% confidence interval of 63.1% to 93.9%. In 4 of the 5 nonvisualized cases, the recipient coronary artery showed proximal stenosis of up to 70%, allowing substantial competitive flow. The 5-year patency of the RGEA graft was near that of the left internal thoracic artery, at 90.3%, and the right internal thoracic artery, at 94.4%; and superior to the 66.7% patency of venous grafts.

Conclusions: At 5-year follow-up, angiography of RGEA grafts showed good function and a smooth lumen, especially if the proximal stenosis was more than 70%.

MeSH terms

  • Abdominal Muscles / blood supply*
  • Arteries / transplantation
  • Confidence Intervals
  • Coronary Angiography*
  • Coronary Artery Bypass / methods*
  • Coronary Circulation
  • Coronary Disease / pathology
  • Coronary Disease / surgery
  • Coronary Vessels / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Omentum / blood supply
  • Survival Rate
  • Thoracic Arteries / transplantation
  • Vascular Patency
  • Veins / transplantation