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Availability of the Skeletonized Gastroepiploic Artery as a Free Graft for Coronary Artery Bypass Grafting  

Ryu Sang-Wan (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Ahn Byong-Hee (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Hong Seong-Beom (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Song Sang-Yun (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Jung In-Suk (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Beom Min-Sun (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Park Jung-Min (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Lee Kyo-Sun (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Ryu Sang-Woo (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Yoon Ju-Sik (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Kim Sang-Hyung (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School University)
Publication Information
Journal of Chest Surgery / v.38, no.9, 2005 , pp. 601-608 More about this Journal
Abstract
Background: To maximize the histological advantage and minimize the physiological disadvantage, we have been using the skeletonized gastroepiploic artey (GEA) as a free graft for total arterial revascularization. The aims of the current study was to assess the efficacy of the skeletonized GEA as a composite or extended graft for total arterial revascularization. Material and Method: Between January 2000 and Feburary 2005, 133 patients (43 female, mean age=61.8 yrs) undergoing coronary artery bypass grafting (CABG) with a skeletonized GEA as free graft (22 extended, 107 composite and 4 others) were enrolled in this study. Coronary angiograms were performed in the immediate (median 44 days, n=86), early (median 366 days, n=56) and midterm (median 984 days, n=29) postoperative periods. Result: There were 3 ($2.2\%$) early and 4 ($3.3\%$) late cardiac-related deaths. The mean number of distal anastomoses per patient was 3.34 for total graft and 1.92 for GEA graft. The immediate, early, and midterm GEA patency were 157/159 ($98.7\%$), 106/142 ($94.6\%$), and 53/56 ($94.6\%$), respectively. During follow-up, four patients required percutaneous intracoronary intervention because of GEA and target coronary artery stenosis or competitive flow. Conclusion: These data demonstrate satisfactory clinical and angiographic results in the skeletonized GEA as free graft for total arterial revascularizatioh. Although we need a careful longer follow-up, the skeletonized GEA as a free graft will be a valuable option 'to be' for CABG.
Keywords
Coronary artery bypass; Conduits; Graft; Gastroepiploic artery graft;
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