Ann Thorac Surg 2009;88:1023. doi:10.1016/j.athoracsur.2008.12.076
© 2009 The Society of Thoracic Surgeons
Images in Cardiothoracic Surgery
Patent Right Gastro-Epiploic Artery Graft to the Left Anterior Descending Artery 14 Years Postoperatively
Harinder Singh Bedi, MCh, FIACS*
Sigma New Life Heart Institute, Ludhiana, Punjab, India
* Address correspondence to Dr Bedi, Cardiac Sciences, Sigma New Life Heart Institute, Kothi No. 562, Ludhiana, Punjab, 160055, India (Email: drhsbedi{at}gmail.com).
A 52-year-old head nurse underwent triple coronary bypass with conduits including the right gastro-epiploic artery (RGEA) and the left internal mammary artery in 1994 for severe triple-vessel disease with insulin-dependent diabetes mellitus. The left internal mammary artery was found to be a little short in reaching the graftable part of the left anterior descending coronary artery (LAD); therefore, the RGEA, which had good flow was anastomosed to the LAD, and the left internal mammary artery was used for the obtuse marginal. We were a bit apprehensive in using the RGEA to the LAD, but it seemed to be a very good sized match. She did very well, was asymptomatic, and came for regular checkups. In 2008, she underwent a self-referred 64-slice computed tomographic angiography. The RGEA was found to be filling the whole of the LAD and was of a good size (Fig 1). There are very few reports of the successful use of the RGEA to the LAD and of postoperative angiography of the same. Our report shows that the RGEA to the LAD can have a good long-term patency.
