In 308
right gastroepiploic artery (GEA) grafting procedures performed for
myocardial revascularization, 38 GEA, 34 in situ, and four free
grafts were used to bypass the
left anterior descending coronary artery (LAD). Indications for using the GEA for the purpose of LAD bypass were: unavailability of the
internal thoracic artery (ITA) at reoperation,
surgical damage to the ITA at the time of the operation, or an apparently better free
flow versus that in the left ITA, particularly in patients with
diabetes mellitus in whom it was considered inadvisable to use bilateral ITAs. There were 21 male and 17 female patients with a
mean age of 62 years (range, 31 to 77 years). Ten patients had undergone a previous
myocardial revascularization. The
mean number of
distal anastomoses was 2.8 (range, 1 to 5).
Concomitantly used conduits were the ITA in 27 patients,
saphenous veins in 21 patients, the
inferior epigastric artery in 4 patients, and the bovine
internal thoracic artery in 1 patient. All but 1 patient survived. Follow-up ranged from 3 to 84 months (
mean, 27 months). Postoperative
angiography was performed in 33 patients. At the short-term evaluation (
mean, 1 month), 32 of 33 (97%) GEA
grafts were found to be patent; all 4 GEA
grafts studied at the long-term evaluation (
mean, 25 months) were also found to be patent. In no patients did angina recur postoperatively. In 25 patients who underwent an exercise study postoperatively, the
stress test results were negative in 23.(ABSTRACT TRUNCATED AT 250 WORDS)
