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Ann Thorac Surg 2002;73:693
© 2002 The Society of Thoracic Surgeons

Correspondence

Left gastric to coronary artery bypass

John B. Flege, Jr, MDa

a 2123 Auburn Ave, no. 401, Cincinnati, OH 45219, USA

e-mail: jflege{at}cvts.com

To the Editor

I agree with Dr van Aarnhem and associates [1] that the left gastric artery may be used in situ for a bypass graft to coronary arteries on the inferior surface of the heart, and have used it in 3 patients in 1988 [2]. A selective left gastric arteriogram shows a patent graft to the posterior descending coronary artery (Fig 1). The left gastric artery is usually of good caliber proximally (diameter of 4 to 5 mm) and tapers rather significantly as it courses along the lesser curvature of the stomach. Its origin is very close to the inferior surface of the heart, to which the shortest route is posterior to the left lobe of the liver and through the diaphragm.



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  		Fig 1. Selective left gastric arteriogram 1 week postoperative showing patent graft to posterior descending coronary artery.

 
References

  1. Van Aarnhem E., Schreur J., Firouzi M., Jansen E. The left gastric artery as an in situ conduit in coronary artery bypass grafting. Ann Thorac Surg 2001;71:1013-1014.[Abstract/Free Full Text]
  2. Flege J.B., Jr Discussion of "Grandjean JG, Boonstra PW, Heyer PD, Ebels T. Arterial revascularization with the right gastroepiploic artery and internal mammary arteries in 300 patients". J Thorac Cardiovasc Surg 1994;107:1316.




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