Late angiographic result of using the right gastroepiploic artery as a graft

Suma, Hisayoshi; Isomura, Tadashi; Horii, Taiko; Satô, Tôru

doi:10.1067/mtc.2000.108690

Cited by 120 publications

(79 citation statements)

References 6 publications

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“…Moreover, angiographically and histologically, the rGEA shows a very low frequency of arteriosclerosis and the mid-term and late angiographic results of the rGEA graft are very satisfactory when compared with vein grafts. In fact, as reported by Suma and co-workers, the patency rate at 10 years is of 62.5% [11]. In a recent report, Hirose [12] compared triple arterial CABG using two groups of patients: BITA plus rGEA vs. BITA plus RA.…”

Section: Discussionmentioning

confidence: 77%

“…This relative high rate of rGEA nonfunctioning grafts, could be caused by degree of proximal stenosis of the target coronary artery, which was equal to or more than 70%. As shown in some reports, the risk of competitive flow and of rGEA occlusion graft is high, if the stenosis of target coronary is less than 90% [11,14,15]. Moreover, an important characteristic of the rGEA is the adaptability to improve its flow in response to augmented metabolic myocardium demand as reported by Tavilla [16,17].…”

Section: Discussionmentioning

confidence: 96%

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Long-term follow-up of total arterial myocardial revascularization using exclusively pedicle bilateral internal thoracic artery and right gastroepiploic artery

Formica¹

2004

European Journal of Cardio-Thoracic Surgery

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Objective: In order to reduce remote cardiac events associated with graft occlusions, arterial conduits are being increasingly utilized in coronary artery bypass grafting (CABG). While the internal thoracic artery (ITA) is the graft of choice for CABG, it is sometimes difficult or impossible to obtain a complete arterial revascularization only with ITAs in three-vessel diseases. We present our experience with total arterial myocardial revascularization with bilateral internal thoracic artery (BITA) and right gastroepiploic artery (rGEA). Methods: From April 1994 to January 2004, 174 patients (165 male, mean age 55.9G7.4) underwent coronary artery bypass procedure with exclusive use of BITA and rGEA. Left ventricular ejection fraction ranged from 20 to 68% (mean 55.9G6.8%). Seven patients (4%) had poor ejection fraction (!0.30), 23 (13, 2%) had acute myocardial infarction, 14 (8%) had left main disease. The mean CPB time was 96.9G15.7 min and the mean cross clamping time was 70G14.2 min. The mean number of distal anastomoses was 3.3G0.5 per patient. Results: Early mortality was 1.7%. The patients were followed for up to 9 years (mean follow-up time 6.3G2.6 years). Actuarial freedom from cardiac death (including hospital death) was 97.6%, at 9 years after the operation. Actuarial freedom from angina and cardiac events at 9 years was 79, 5% and 77, 6%, respectively. No perioperative myocardial infarction occurred. None of the patients needed a redo-CABG after leaving the hospital. Conclusions: This study indicates that the myocardial revascularization in young patients with three-vessel disease using exclusively pedicle BITA and rGEA provides excellent 9-year patient survival and improvement in terms of freedom from return of angina pectoris and freedom from any cardiac-related event. These results encourage the more extensive use of BITA and rGEA in selected patients with three-vessel coronary disease. q

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 96%

Long-term follow-up of total arterial myocardial revascularization using exclusively pedicle bilateral internal thoracic artery and right gastroepiploic artery

Formica¹

2004

European Journal of Cardio-Thoracic Surgery

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“…Risk factors for late occlusion were primary anastomotic stenosis and less critical stenosis in the grafted coronary artery as described previously. 6 A skeletonized GEA graft was preferentially used over the last 5 years on 203 patients. A postoperative angiography was performed in 172 skeletonized GEA grafts with 233 distal anastomoses, and the patency rate at immediate, 1, and 4 years after surgery was 97.6%, 92.9%, and 86.4%, respectively.…”

Section: Resultsmentioning

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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“…9 The patency status of the skeletonized GEA graft, such as string sign or flow physiology against competitive flow, is a matter of interest in comparison with the conventional pedicle GEA graft. Our study is ongoing following an increasing number of repeat studies with more precise analysis.…”

Section: Discussionmentioning

confidence: 99%

Midterm Results for Use of the Skeletonized Gastroepiploic Artery Graft in Coronary Artery Bypass

Suma

Tanabe

Yamada

et al. 2007

Circ J

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Late angiographic result of using the right gastroepiploic artery as a graft

Abstract: The gastroepiploic artery graft can be used effectively for coronary artery bypass for the long term with proper target selection.

Cited by 120 publications

References 6 publications

Long-term follow-up of total arterial myocardial revascularization using exclusively pedicle bilateral internal thoracic artery and right gastroepiploic artery

Long-term follow-up of total arterial myocardial revascularization using exclusively pedicle bilateral internal thoracic artery and right gastroepiploic artery

Twenty Years Experience With the Gastroepiploic Artery Graft for CABG

Midterm Results for Use of the Skeletonized Gastroepiploic Artery Graft in Coronary Artery Bypass

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