Coronary artery bypass grafting using the right gastroepiploic artery
Suma, H.; Fukumoto, H.; Takeuchi, A.
Nihon Kyobu Geka Gakkai 36(8): 1347-1351
1988
ISSN/ISBN: 0369-4739 PMID: 3264000 Document Number: 309489
The great saphenous vein (SV) and the internal mammary artery (IMA) are the graft of choice in coronary bypass surgery at present. However, in this time of the year when those two kinds of the grafts were not available or which were already used at the previous surgery, we have to use another reliable graft as "the third graft material". In this communication, authors have presented three successful cases of coronary artery bypass graftings using the right gastroepiploic artery (GEA) as "the new arterial graft". Routine midline sternal incision was extended to just above the umbilicus. The GEA was mobilized around from the stomach along the greater curvature and was divided at the left side at most. This in-situ GEA pedicle was found to be long enough to reach the three main coronary arterial branches for anastomosis. We have performed two cases of GEA grafting to the left anterior descending arteries and other one graft to the right coronary artery in combination with IMA or SV grafts without any difficulty. Postoperative arteriography showed an excellent functioning patency of these grafts and these patients were completely free from angina pectoris after the operation. We concluded that the in-situ GEA grafting for myocardial revascularization can be done with reasonable success and its utilization may open the avenue to perform the complete revascularization only with the arterial graft material when combined with the IMA grafts.