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Ann Thorac Surg 1989;47:712-715
© 1989 The Society of Thoracic Surgeons


Articles

Myocardial revascularization with combined arterial grafts utilizing the internal mammary and the gastroepiploic arteries

Hisayoshi Suma, MD*, Atsuro Takeuchi, MD, Yuzo Hirota, MD

Department of Thoracic Surgery and the Third Division of the Department of Internal Medicine, Osaka Medical College, Osaka, Japan

Accepted for publication November 16, 1988.

* Address reprint requests to Dr Suma, Department of Cardiovascular Surgery, Mitsui Memorial Hospital, 1-Kanda Izumicho, Chiyodaku, Tokyo 101, Japan.

Coronary artery bypass grafting with a combined arterial graft using both the internal mammary artery and the right gastroepiploic artery was performed in 22 patients during a 21-month period. There were 17 men and 5 women ranging in age from 34 to 73 years (mean age, 53.4 years). Three patients were having a reoperation, and 2 patients had no segment of long saphenous vein available. Twelve patients were less than 55 years old. The mean number of distal anastomoses including vein grafts was 3.2 and the mean number of arterial grafts was 2.5 per patient. The mean aortic cross-clamp time was 63.8 minutes and the mean cardiopulmonary bypass time was 116.7 minutes. There was 1 early and 1 late death. The other 20 patients are alive without angina. Studied within 3 postoperative months, graft patency was 95% ([equation]) in internal mammary artery and 93% ([equation]) in gastroepiploic artery grafts. It is concluded that the combined arterial graft can be used safely and effectively, and its application facilitates complete revascularization with more arterial and fewer vein grafts.




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