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Right gastroepiploic artery for revascularization of the right coronary territory in off-pump total arterial revascularization: strategies to improve patency.
Ann Thorac Surg. 2006 Jun; 81(6):2135-41.AT

Abstract

BACKGROUND

We evaluated the early and 1-year postoperative results of grafting the skeletonized right gastroepiploic artery to the right coronary territories.

METHODS

One hundred and seventy-five patients who underwent off-pump total arterial revascularization using the skeletonized right gastroepiploic artery and bilateral internal thoracic arteries were studied. The right gastroepiploic artery was used for revascularizing the right coronary territories, and bilateral internal thoracic arteries were used for revascularizing the left coronary territories. We revised the in-situ right gastroepiploic artery graft into a composite or free graft if the flowmeter measurement suggested a competitive flow pattern. Postoperative angiographies were performed in 98.3% of the patients before discharge, and in 92.0% of the patients 1 year after surgery.

RESULTS

Hospital mortality was 0.6%. Postoperative angiography showed early patency rate of 98.3% for the right gastroepiploic artery and 99.4% for the internal thoracic artery (p = 0.352), and 1-year patency rate of 92.0% for the right gastroepiploic artery and 97.2% for the internal thoracic artery (p = 0.009). Flow competition of the right gastroepiploic artery was observed in 5.2% of the patients at the early postoperative angiography and in 6.8% of the patients 1 year after surgery. The incidence of right gastroepiploic artery graft flow competition was significantly decreased compared with that of the pre-flowmeter period (p = 0.036 at early angiography; p = 0.017 at 1-year angiography).

CONCLUSIONS

The skeletonized right gastroepiploic artery grafted to the right coronary territory demonstrated excellent early and 1-year patency rates. Flow competition of the in situ right gastroepiploic artery may be overcome by intraoperative revision of graft based on flow measurement.

Authors+Show Affiliations

Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. kimkb@snu.ac.krNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

16731142

Citation

Kim, Ki-Bong, et al. "Right Gastroepiploic Artery for Revascularization of the Right Coronary Territory in Off-pump Total Arterial Revascularization: Strategies to Improve Patency." The Annals of Thoracic Surgery, vol. 81, no. 6, 2006, pp. 2135-41.
Kim KB, Cho KR, Choi JS, et al. Right gastroepiploic artery for revascularization of the right coronary territory in off-pump total arterial revascularization: strategies to improve patency. Ann Thorac Surg. 2006;81(6):2135-41.
Kim, K. B., Cho, K. R., Choi, J. S., & Lee, H. J. (2006). Right gastroepiploic artery for revascularization of the right coronary territory in off-pump total arterial revascularization: strategies to improve patency. The Annals of Thoracic Surgery, 81(6), 2135-41.
Kim KB, et al. Right Gastroepiploic Artery for Revascularization of the Right Coronary Territory in Off-pump Total Arterial Revascularization: Strategies to Improve Patency. Ann Thorac Surg. 2006;81(6):2135-41. PubMed PMID: 16731142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Right gastroepiploic artery for revascularization of the right coronary territory in off-pump total arterial revascularization: strategies to improve patency. AU - Kim,Ki-Bong, AU - Cho,Kwang Ree, AU - Choi,Jae-Sung, AU - Lee,Hyun-Joo, PY - 2005/09/22/received PY - 2006/01/05/revised PY - 2006/01/09/accepted PY - 2006/5/30/pubmed PY - 2007/9/28/medline PY - 2006/5/30/entrez SP - 2135 EP - 41 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 81 IS - 6 N2 - BACKGROUND: We evaluated the early and 1-year postoperative results of grafting the skeletonized right gastroepiploic artery to the right coronary territories. METHODS: One hundred and seventy-five patients who underwent off-pump total arterial revascularization using the skeletonized right gastroepiploic artery and bilateral internal thoracic arteries were studied. The right gastroepiploic artery was used for revascularizing the right coronary territories, and bilateral internal thoracic arteries were used for revascularizing the left coronary territories. We revised the in-situ right gastroepiploic artery graft into a composite or free graft if the flowmeter measurement suggested a competitive flow pattern. Postoperative angiographies were performed in 98.3% of the patients before discharge, and in 92.0% of the patients 1 year after surgery. RESULTS: Hospital mortality was 0.6%. Postoperative angiography showed early patency rate of 98.3% for the right gastroepiploic artery and 99.4% for the internal thoracic artery (p = 0.352), and 1-year patency rate of 92.0% for the right gastroepiploic artery and 97.2% for the internal thoracic artery (p = 0.009). Flow competition of the right gastroepiploic artery was observed in 5.2% of the patients at the early postoperative angiography and in 6.8% of the patients 1 year after surgery. The incidence of right gastroepiploic artery graft flow competition was significantly decreased compared with that of the pre-flowmeter period (p = 0.036 at early angiography; p = 0.017 at 1-year angiography). CONCLUSIONS: The skeletonized right gastroepiploic artery grafted to the right coronary territory demonstrated excellent early and 1-year patency rates. Flow competition of the in situ right gastroepiploic artery may be overcome by intraoperative revision of graft based on flow measurement. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/16731142/Right_gastroepiploic_artery_for_revascularization_of_the_right_coronary_territory_in_off_pump_total_arterial_revascularization:_strategies_to_improve_patency_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(06)00053-1 DB - PRIME DP - Unbound Medicine ER -