ANGIOGRAPHIC 5-YEAR FOLLOW-UP-STUDY OF RIGHT GASTROEPIPLOIC ARTERY GRAFTS

Background. The right gastroepiploic artery (RGEA) has been used from 1987 in coronary artery bypass grafting in several clinical studies. H owever, the published 1- to 5-year patency rates have been dependent o n the selection of patients for angiography. Methods. In our study, th e RGEA was used from March 1987 to May 1990 for coronary artery bypass grafting in 31 consecutive patients, 25 male and 6 female. All but 1 patient had triple-vessel disease, and the mean number of distal anast omoses was 3.9 (range, 2 to 5). Internal thoracic artery grafts were u sed concomitantly in all patients. Results. One early and two late dea ths occurred. All but 1 of the 28 surviving patients underwent clinica l and angiographic follow-up examinations 3 months and 5 years after t he operation. The 5-year patency of RGEA grafts was 82.1%, with a 95% confidence interval of 63.1% to 93.9%. In 4 of the 5 nonvisualized cas es, the recipient coronary artery sl;owed proximal stenosis of up to 7 0%, allowing substantial competitive now. The 5-year patency of the RG EA graft was near that of the left internal thoracic artery, at 90.3%, and the right internal thoracic artery, at 94.4%; and superior to the 66.7% patency of venous grafts. Conclusions. At 5-year follow-up, ang iography of RGEA grafts showed good function and a smooth lumen, espec ially if the proximal stenosis was more than 70%.