Use of the right gastroepiploic artery as a coronary artery bypass graft in 307 patients

被引：24

作者：

Albertini, A ^{[1
]}

Lochegnies, A ^{[1
]}

El Khoury, G ^{[1
]}

Verhelst, R ^{[1
]}

Noirhomme, P ^{[1
]}

Matta, A ^{[1
]}

Jacquet, L ^{[1
]}

Underwood, MJ ^{[1
]}

Dion, R ^{[1
]}

机构：

[1] Univ Catholique Louvain, Clin Univ St Luc, Dept Cardiovasc & Thorac Surg, B-1200 Brussels, Belgium

来源：

CARDIOVASCULAR SURGERY | 1998年 / 6卷 / 04期

关键词：

gastroepiploic artery; coronary artery bypass; patency; clinical outcome;

D O I：

10.1016/S0967-2109(98)00009-X

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

From October 1988 to October 1995 the right gastroepiploic artery was used as a conduit for coronary surgery in 307 patients. Their average age was 56.5 years (range 25-75) and 274 patients (89%) were male. Twenty-six cases (8.5%) were re-operations and 58 patients (19%) were operated upon on an urgent or semi-urgent basis. Target coronary vessels were the right coronary artery and its branches in 280 cases (91.4%), the circumflex artery in 25 cases (8%) and the left anterior descending artery in two cases. The right gastroepiploic artery was used as an in situ graft in 303 cases (98.7%) and as a free graft in 4 (1.3%). A total of 291 patients (94.8%) also received at least one mammary artery graft: both mammary arteries were used in 167 patients (54.4%). An average of 3.6 distal anastomoses were made per patient, three of them with arterial grafts. Eleven (3.2%) right gastroepiploic artery grafts were doubled with saphenous vein intraoperatively because of persistent myocardial ischemia, In-hospital mortality was 1.6% (five patients). Perioperative myocardial infarction occurred in twelve patients (3.9%). Follow-up now averages 26 months (range 6-88), There have been Rye late deaths (1.6%). A total of 265 (89.2%) patients are angina free. Of the total, 145 patients have been investigated with a maximal-stress test coupled with scintigraphy: residual myocardial ischemia was found in 10 patients, right gastroepiploic artery was related in three. Ninety-six patients have undergone angiographic restudy at a mean of 12 months (range 8-88) postoperatively. Patency of the right gastroepiploic artery grafts was 91.8%. This study confirms that the right gastroepiploic artery can be used as a conduit for coronary artery bypass surgery with minimal mortality or morbidity, Mid-term patency rates and clinical outcome are encouraging. (C) 1998 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.

引用

页码：419 / 423

页数：5