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The Annals of Thoracic Surgery, Vol 57, 925-927, Copyright © 1994 by The Society of Thoracic Surgeons
H Suma, A Amano, S Fukuda, I Kigawa, T Horii, Y Wanibuchi and A Nabuchi
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)
ARTICLES
Gastroepiploic artery graft for anterior descending coronary artery bypass
Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
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