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Ann Thorac Surg 2008;86:1444-1449. doi:10.1016/j.athoracsur.2008.06.055
© 2008 The Society of Thoracic Surgeons
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Naoki Minato
Hisashi Satoh
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Original Articles: Adult Cardiac

Preoperative Evaluation of the Right Gastroepiploic Artery on Multidetector Computed Tomography in Coronary Artery Bypass Graft Surgery

Keiji Kamohara, MD, PhD*, Naoki Minato, MD, PhD, Noritoshi Minematsu, MD, Junji Yunoki, MD, Takeshi Hakuba, MD, Hisashi Satoh, MD, Hiroyuki Morokuma, MD, Yuichi Takao, RT

Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, Kasuga City, Fukuoka, Japan

Accepted for publication June 17, 2008.

* Address correspondence to Dr Kamohara, Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, 4-5 Suku-kita, Kasuga City, Fukuoka, 816-0871, Japan (Email: keijikamohara{at}hotmail.com).

Background: The right gastroepiploic artery (GEA) is commonly used in coronary artery bypass grafting, but a method for preoperative assessment of the suitability of the GEA has not been established. Here, we assessed the efficacy of 64-slice multidetector computed tomography (MDCT) for this purpose.

Methods: Multidetector computed tomography was performed for 32 patients (24 males, 8 females; mean age, 65.9 ± 7.4 years) undergoing coronary artery bypass graft surgery. Preoperative MDCT criteria for GEA suitability were no significant stenosis or calcification and a diameter of 2.0 mm or more in the middle portion of the GEA. The skeletonized GEA was inspected in 30 patients to determine the accuracy of evaluation of arteriosclerosis by MDCT (2 patients were excluded owing to severe GEA stenosis). The internal diameter at the anastomotic site was compared with the diameters of the proximal, distal, and middle regions of the GEA on MDCT.

Results: The GEA was used to bypass a target coronary artery in 30 patients. The diameter of the middle of the GEA on MDCT correlated strongly with the actual internal diameter at the anastomotic site (r = 0.72, p < 0.0001). The diameter at the anastomotic site calculated from MDCT using the distance from the GEA origin to the anastomotic site and the actual diameter did not differ significantly (2.76 ± 0.6 versus 2.87 ± 0.5 mm, p = 0.06).

Conclusions: Preoperative MDCT imaging of the GEA is reliable for diagnosis, and a middle diameter of 2.0 mm or greater can be used to indicate GEA suitability for coronary artery bypass grafting.


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Invited Commentary
Jacob Bergsland
Ann. Thorac. Surg. 2008 86: 1449. [Extract] [Full Text] [PDF]



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J. Bergsland
Invited Commentary
Ann. Thorac. Surg., November 1, 2008; 86(5): 1449 - 1449.
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