Midterm results for use of the skeletonized gastroepiploic artery graft in coronary artery bypass

Abstract

Background: To improve the long-term results of coronary artery bypass grafting (CABG), several arterial conduits have been used, including the skeletonized right gastroepiploic artery (GEA) graft.

Methods and results: The skeletonized GEA graft was used for CABG in 223 patients over a 6-year period (208 males, 15 females, mean age 64 years). 1-, 2- and 3-vessel and left main trunk disease was noted in 1, 28, 122 and 72 patients, respectively. Internal thoracic artery, radial artery and saphenous vein grafts were concomitantly used in 217 (97%), 73 (33%) and 41 (18%) patients, respectively, and the mean number of grafts was 3.5. The sites of GEA grafting were 1 anterior descending, 10 diagonal, 97 circumflex, and 185 right coronary arteries, with 154 single in-situ, 33 free and 36 composite grafts, including 56 sequential grafts. There was 1 (0.4%) operative death. New Q wave was noted in 2 (0.9%) patients. Postoperative angiography revealed 97.6% early postoperative (within 1 month) and 91.5% midterm (mean 27 months) patency rates for GEA grafts. The cumulative 4-year patency rate of the skeletonized GEA graft was 86.4%.

Conclusion: The skeletonized GEA is a safe and effective arterial conduit for CABG.