Document Detail

Transplantation of the free gastroepiploic artery graft for myocardial revascularization: long-term clinical and angiographic results.
MedLine Citation:
PMID:  18291162     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Use of the free gastroepiploic artery (GEA) graft for coronary revascularization is not very popular because of its tendency to vasospasm. We hypothesize that the cause of free GEA spasm is graft damage caused by an interruption of venous drainage from the graft. To overcome this problem, we anastomosed the accompanied gastroepiploic vein to the right atrial appendage simultaneously with the GEA grafting in the aortocoronary position. We here assess the clinical result and the angiographic patency of the free GEA graft in our method in the late postoperative period. METHODS: Between January 1997 and April 2001, 57 patients underwent coronary artery grafting with a free GEA using our method. A total of 169 distal anastomoses (average 2.96) were constructed. The free GEA grafts were anastomosed to the main right coronary artery in 26 patients, right coronary artery branch in 27, left anterior descending artery in 1 patient, high lateral branch in 2 patients, and circumflex branch in 2. The mean clinical follow-up is 77 months (range, 35 to 110) in 57 cases, and the angiographic follow-up averages 77 months (range, 37 to 110) in 46 cases. RESULTS: There was no cardiac death, and all patients were in Canadian Cardiovascular Society class II or less. The mean 77-month patency rate of the free GEA in our method was 95.7%. The patency rates of internal thoracic artery, radial artery, and saphenous vein graft in the same period were respectively 93.2%, 100%, and 81.3%. CONCLUSIONS: Free GEA grafting with venous drainage for myocardial revascularization provided excellent long-term performance.
Tadahito Eda; Akio Matsuura; Ken Miyahara; Haruki Takemura; Sadanari Sawaki; Teruaki Yoshioka; Naoki Yoshida
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-22     Completed Date:  2008-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  880-4     Citation Subset:  AIM; IM    
Department of Cardiovascular Surgery, Aichi Cardiovascular and Respiratory Center, Aichi, Japan.
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MeSH Terms
Gastroepiploic Artery / physiology,  radiography*,  transplantation*
Middle Aged
Myocardial Revascularization / methods*
Retrospective Studies
Time Factors
Vascular Patency
Comment In:
Ann Thorac Surg. 2008 Mar;85(3):884   [PMID:  18291163 ]

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