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

Albertini, Alberto; Lochegnies, A; Khoury, Gébrine El; Verhelst, Robert; Noirhomme, Philippe; Matta, Amine; Jacquet, Luc‐Marie; Underwood, Malcolm J.; Dion, Robert

doi:10.1016/s0967-2109(98)00009-x

Cited by 29 publications

(15 citation statements)

References 19 publications

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“…The most frequently targeted area is the RCA 19,34,83 and sometimes the CX. The early patency rate of the RGEA was 91.8 to 100% 4,6,13,18,29,32,34,43,50 when used as an in situ graft or as inflow of a composite graft, as shown in Table 1. When the RGEA was used as a free graft, it ranged from 70% to 100%, 33,54,83 as shown in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Many surgeons have been using papeverine externally or intraluminally to relieve spasm when harvesting the RGEA. 19,23,[28][29][30][31][32][33][34][35][36][37][38] Hirose et al mentioned that the RGEA can be dilated from 1.5 mm to 2.0 mm to 2.5 mm by papaverine injection. 19 Formica et al used glyceryl-verapamil solution as well as papaverine.…”

Section: Spasm Of Rgeamentioning

confidence: 99%

“…The main target of the RGEA is the RCA, 4,[18][19][20][28][29][30]32,34,41,43,[45][46][47][48] especially its distal part. 19,20,23,30,32,41,45,47 The CX is a possible target when the graft is long enough.…”

Section: Distal Anastomosis Of Rgeamentioning

confidence: 99%

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The Right Gastroepiploic Artery in Coronary Artery Bypass Grafting

Sasaki

2008

Journal of Cardiac Surgery

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The right gastroepiploic artery (RGEA) has been used as a conduit in coronary artery bypass grafting. Although some reports presenting good results justify its use in clinical settings, there is still much concern about using the RGEA in bypass surgery. The RGEA demonstrates different behaviors from the internal thoracic artery (ITA) in bypass surgery due to its histological characteristics and anatomical difference, which might contribute to the long-term outcome. Now that left ITA (LITA) to left anterior descending artery (LAD) is the gold standard, other grafts are expected to cover the rest of the coronary arteries. It should be elucidated how we can use other grafts and what we can expect from them. RGEA, as an arterial graft, can be used as an in situ graft or a free graft. The RGEA is mainly used to graft to the right coronary artery (RCA) because of its anatomical position, and its patency is not inferior to that of the saphenous vein (SVG). The RGEA can cover the lateral walls when its length is long enough or by making a composite graft with other grafts. However, when used to graft to the LAD, its mid-term patency is not favorable.

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Section: Resultsmentioning

confidence: 99%

Section: Spasm Of Rgeamentioning

confidence: 99%

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The Right Gastroepiploic Artery in Coronary Artery Bypass Grafting

Sasaki

2008

Journal of Cardiac Surgery

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“…In general, skeletonization of an arterial graft increases the length and flow capacity, and facilitates handling of the graft. 15,16 Acceptable early results of skeletonized in-situ GEA grafts in 168 patients have been reported. 10 However, this report did not mention free GEA grafting.…”

Section: Discussionmentioning

confidence: 99%

En-Bloc Free Gastroepiploic Artery Graft Provides a Good Long-Term Patency Rate

Eda

Miyahara²,

Oshima

et al. 2010

Asian Cardiovasc Thorac Ann

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For coronary artery bypass grafting, the use of free gastroepiploic artery is unpopular because of its tendency to vasospasm. We assessed the en-bloc free gastroepiploic artery graft, which has the gastroepiploic vein anastomosed to the right atrial appendage to prevent graft spasm, and compared it to the skeletonized free gastroepiploic artery graft. A retrospective review was conducted in 57 patients who received en-bloc grafts and 29 who had skeletonized grafts. Kaplan-Meier analysis demonstrated the superiority of the en-bloc free gastroepiploic artery graft with an 80-month patency rate of 96.6% compared to 66.7% with skeletonized grafts. We selected 13 cases from each group, using propensity-score matching, and compared the long-term patency rates. Propensity-score matched analysis showed 80-month patency rates of 100% for en-bloc grafts and 60% for skeletonized grafts. Coronary artery bypass using free gastroepiploic artery grafts with venous drainage seems to provide good long-term results.

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“…Patients' basal demographic and clinical characteristics are shown in Table 2. The RGEA and the SVG were harvested and grafted as previously described (12,13). The RGEA diameter was measured pre-operatively with a 1.5-mm probe.…”

Section: Patientsmentioning

confidence: 99%