Coronary artery bypass grafting using the gastroepiploic artery in 1,000 patients

Hirose, Hitoshi; Amano, Atushi; Takanashi, Shuichirou; Takahashi, Akihito

doi:10.1016/s0003-4975(02)03416-1

Cited by 81 publications

(47 citation statements)

References 19 publications

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“…12,13 Several investigators have shown that GEA can be used without increased morbidity, particularly in abdominal complications, 14,15 and the late survival rate has been excellent in CABG with GEA plus internal thoracic artery grafts. 4,15,16,17 In our present study, 5-, 10-, and 15-year actuarial survival rates in 1118 follow-up patients were 91.7%, 81.4%, and 71.3%, and the cardiac death-free survival rates were 95.8%, 91.7%, and 88.6%, respectively. The survival rate in the subgroup having bilateral internal thoracic artery and GEA grafts was higher than that of the other group using single internal thoracic artery and GEA grafts, but there was no statistical significance at this point in time.…”

Section: Discussionmentioning

confidence: 99%

Twenty Years Experience With the Gastroepiploic Artery Graft for CABG

et al. 2007

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Background-To improve the longterm outcome after CABG, several strategies have been used using arterial conduits.Our 20 years experience with the right gastroepiploic artery (GEA) graft was evaluated. Methods and Results-In 1352 patients having CABG with the GEA graft, (1092 men, mean 63 years, 99% multivessel disease, and mean EF 0.51), internal thoracic artery, saphenous vein, and radial artery grafts were concomitantly used in 1312 (97%), 783 (58%), and 128 (8%) patients, respectively. The mean number of distal anastomoses was 3.1, and 2.4 coronary arteries were bypassed with arterial grafts. The sites for GEA grafting were 70 anterior descending, 268 circumflex, and 1089 right coronary arteries. The operative mortality was 1.26%. In 1118 follow-up patients (82.6%), 5, 10, and 15 years survival rates were 91.7%, 81.4%, and 71.3%, and the cardiac death-free survival rates were 95.8%, 91.7%, and 88.6%, respectively. The cumulative patency rate of the GEA graft was 97.1% at 1 month, 92.3% at 1 year, 85.5% at 5 years, and 66.5% at 10 years, respectively. In 172 skeletonized GEA grafts with 233 distal anastomoses, the patency rate at immediate, 1, and 4 years after surgery was 97.6%, 92.9%, and 86.4%, respectively. In 124 patients with late (5 to 17 years) restudy, patency rate was 96% (114/119) in the left internal thoracic artery, 87% (108/124) in GEA, and 68% (67/98) in saphenous vein grafts. New stenosis was uncommon in GEA. Conclusion-The

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Section: Discussionmentioning

confidence: 99%

Twenty Years Experience With the Gastroepiploic Artery Graft for CABG

et al. 2007

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“…In a real world, although multiple studies also demonstrated excellent surgical outcomes of CABG using GEA graft [84][85][86][87], GEA is rarely used in the United States mainly due to technical complexity.…”

Section: Cabg Using Right Gastroepiploic Arterymentioning

confidence: 99%

The Choice of Graft Conduits in Coronary Artery Bypass Grafting

Murashita¹

2017

Coronary Artery Bypass Graft Surgery

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The use of the left internal mammary artery (IMA) has been shown to improve longterm survival and has been a gold standard in coronary artery bypass grafting (CABG). However, the choice of second or third graft conduit is still controversial. Multiple studies demonstrated the beneit of using multiple arterial grafts such as right IMA and radial artery in addition to left IMA in terms of long-term survival and graft patency. However, most of the centers still perform CABG with one IMA and vein grafts in a real world. The challenges for bilateral IMA utilization include longer operative time and concerns for higher rates of perioperative morbidity and mortality associated with increased sternal wound infection. Several studies reported that skeletonization technique can reduce the risk of sternal wound infection. Radial artery is another arterial conduit, which does not increase the risk of sternal wound infection and is easy to harvest. The superiority between radial artery and right IMA has been controversial. In the meantime, multiple trials have been made to improve the patency of vein grafts. The choice of graft conduits in CABG should be well considered preoperatively based on each patient's backgrounds.

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“…Several investigators have shown that GEA can be used without increased morbidity, particularly in abdominal complications [65,66], and the late survival rate has been excellent in CABG with GEA plus internal thoracic artery grafts [18,56,67,68].…”

Section: The Right Gastroepiploic Artery (Rgea)mentioning

confidence: 99%

Coronary artery bypass grafting in diabetic patients: Should we still use the saphenous vein graft? A review of literature in the past 15 years

Molardi¹,

Benassi²,

Nicolini³

et al. 2013

WJCD

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The burden of diseases associated with diabetes mellitus is dramatic: adults with diabetes mellitus are 2 to 4 times more likely to have cardiovascular diseases than those without it, and at least 65% will die because of diabetes complications. The revascularization strategy in these types of patients included percutaneous coronary interventions with bare metal stents or medicated stents and surgical coronary artery bypass grafting (CABG), but it is well known that in the diabetic patient with two or more vessel disease, the surgical strategy allows the best mid-and longterm results. Moreover, benefits of CABG surgery are limited by life expectancy of the most common type of graft, the saphenous vein (SV). Nearly 40 years after the introduction of bypass surgery, the rate of vein graft failure remains at high levels. Several arterial conduits had been studied as alternative conduits to SV: the Right Internal Thoracic Artery (RITA), the Radial Artery (RA), the Gastroepiploic Artery (GEA) and the Inferior Epigastric Artery (IEA), 40 years ago. The aim of our article is to review the scientific literature of the past 15 years to answer this question: are we ready to treat the diabetic patient, with a completely arterial revascularization, avoiding the use of the great saphenous vein grafts?

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Coronary artery bypass grafting using the gastroepiploic artery in 1,000 patients

Cited by 81 publications

References 19 publications

Twenty Years Experience With the Gastroepiploic Artery Graft for CABG

Twenty Years Experience With the Gastroepiploic Artery Graft for CABG

The Choice of Graft Conduits in Coronary Artery Bypass Grafting

Coronary artery bypass grafting in diabetic patients: Should we still use the saphenous vein graft? A review of literature in the past 15 years

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