Tags

Type your tag names separated by a space and hit enter

Right gastroepiploic artery used for coronary artery bypass grafting. Evaluation of flow characteristics and size.
J Thorac Cardiovasc Surg. 1993 Oct; 106(4):579-85; discussion 586.JT

Abstract

Questions remain concerning the physiologic capabilities of the right gastroepiploic artery as a bypass graft in the clinical setting. Our last 90 consecutive pedicle right gastroepiploic artery grafts were prepared with intraluminal papaverine and verapamil. Our series comprised 81 male and 9 female patients with average body surface areas of 1.92 m2. Ages ranged from 11 to 79 years (mean 57.2 years). A second to fourth revascularization was undertaken in 32 patients (35.5%). The following arteries were bypassed: posterior descending artery, 63; right coronary artery, 23; distal right, 4; circumflex, 2; left anterior descending, 1; and diagonal, 1. Free flow rates ranged from 42 to 660 ml/min (mean 179.96 ml/min). Internal diameters measured 1.5 to 4.0 mm (mean 2.20 mm) at the anastomotic sites. Pedicle lengths ranged from 16 to 26 cm (mean 19.2 cm). Inotropic support was required in 11 patients (12%) and had no adverse effects on right gastroepiploic artery grafts. There were 2 hospital deaths (2.2%). Angina has recurred in 6 patients. One patient with cardiomyopathy required transplantation 2 years after coronary bypass grafting. Repeat angiography showed widely patent grafts in 18 patients and generalized narrowing in 4 grafts. In only 2 patients of our total experience has right gastroepiploic artery grafting been aborted because of inadequate conduit size. One right gastroepiploic artery had visible atherosclerosis. This study shows that distal right gastroepiploic artery sizes are comparable with sizes of target coronary arteries. However, neither flow nor size is as consistent when compared with internal thoracic artery grafts. Higher flow rates are related to graft anatomic characteristics and larger body surface areas. Spasm, secondary to harvest in these vasoreactive grafts, can be managed appropriately by intraluminal vasodilating drugs. However, use of the right gastroepiploic artery should be avoided in a setting with possible competition of flow.

Authors+Show Affiliations

Mills Cardiovascular, New Orleans, La.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8412249

Citation

Mills, N L., et al. "Right Gastroepiploic Artery Used for Coronary Artery Bypass Grafting. Evaluation of Flow Characteristics and Size." The Journal of Thoracic and Cardiovascular Surgery, vol. 106, no. 4, 1993, pp. 579-85; discussion 586.
Mills NL, Hockmuth DR, Everson CT, et al. Right gastroepiploic artery used for coronary artery bypass grafting. Evaluation of flow characteristics and size. J Thorac Cardiovasc Surg. 1993;106(4):579-85; discussion 586.
Mills, N. L., Hockmuth, D. R., Everson, C. T., & Robart, C. C. (1993). Right gastroepiploic artery used for coronary artery bypass grafting. Evaluation of flow characteristics and size. The Journal of Thoracic and Cardiovascular Surgery, 106(4), 579-85; discussion 586.
Mills NL, et al. Right Gastroepiploic Artery Used for Coronary Artery Bypass Grafting. Evaluation of Flow Characteristics and Size. J Thorac Cardiovasc Surg. 1993;106(4):579-85; discussion 586. PubMed PMID: 8412249.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Right gastroepiploic artery used for coronary artery bypass grafting. Evaluation of flow characteristics and size. AU - Mills,N L, AU - Hockmuth,D R, AU - Everson,C T, AU - Robart,C C, PY - 1993/10/1/pubmed PY - 1993/10/1/medline PY - 1993/10/1/entrez SP - 579-85; discussion 586 JF - The Journal of thoracic and cardiovascular surgery JO - J Thorac Cardiovasc Surg VL - 106 IS - 4 N2 - Questions remain concerning the physiologic capabilities of the right gastroepiploic artery as a bypass graft in the clinical setting. Our last 90 consecutive pedicle right gastroepiploic artery grafts were prepared with intraluminal papaverine and verapamil. Our series comprised 81 male and 9 female patients with average body surface areas of 1.92 m2. Ages ranged from 11 to 79 years (mean 57.2 years). A second to fourth revascularization was undertaken in 32 patients (35.5%). The following arteries were bypassed: posterior descending artery, 63; right coronary artery, 23; distal right, 4; circumflex, 2; left anterior descending, 1; and diagonal, 1. Free flow rates ranged from 42 to 660 ml/min (mean 179.96 ml/min). Internal diameters measured 1.5 to 4.0 mm (mean 2.20 mm) at the anastomotic sites. Pedicle lengths ranged from 16 to 26 cm (mean 19.2 cm). Inotropic support was required in 11 patients (12%) and had no adverse effects on right gastroepiploic artery grafts. There were 2 hospital deaths (2.2%). Angina has recurred in 6 patients. One patient with cardiomyopathy required transplantation 2 years after coronary bypass grafting. Repeat angiography showed widely patent grafts in 18 patients and generalized narrowing in 4 grafts. In only 2 patients of our total experience has right gastroepiploic artery grafting been aborted because of inadequate conduit size. One right gastroepiploic artery had visible atherosclerosis. This study shows that distal right gastroepiploic artery sizes are comparable with sizes of target coronary arteries. However, neither flow nor size is as consistent when compared with internal thoracic artery grafts. Higher flow rates are related to graft anatomic characteristics and larger body surface areas. Spasm, secondary to harvest in these vasoreactive grafts, can be managed appropriately by intraluminal vasodilating drugs. However, use of the right gastroepiploic artery should be avoided in a setting with possible competition of flow. SN - 0022-5223 UR - https://www.unboundmedicine.com/medline/citation/8412249/Right_gastroepiploic_artery_used_for_coronary_artery_bypass_grafting__Evaluation_of_flow_characteristics_and_size_ L2 - https://medlineplus.gov/coronaryarterybypasssurgery.html DB - PRIME DP - Unbound Medicine ER -