COMPLETE ARTERIAL MYOCARDIAL REVASCULARIZATION USING THE RIGHT GASTROEPIPLOIC ARTERY AND BOTH INTERNAL THORACIC ARTERIES AS PEDICLED GRAFTS

To achieve complete arterial myocardial revascularization without vein grafts, the right gastroepiploic artery and both internal thoracic ar teries were used as pedicled grafts in 105 patients from March 1989 to July 1994. There were 101 male and 4 female patients, with a mean age of 51 years (range 32 to 65 years), Three-vessels disease was present in all patients, Six patients underwent previous bypass procedures wi th the use of vein grafts. A total of 363 distal anastomosis (108 with the right gastroepiploic artery, 255 with both internal thoracic arte ries) were constructed, The mean number of distal anastomoses was 3.4. There was no hospital mortality, Seven patients required a rethoracot ony: 5 because of post-operative signs of ischemia, 2 because of bleed ing. In one patient a splenectomie had to be performed because of blee ding. A new Q wave was noted in 2 patients, Follow-up averaged 21 mont hs (range 1 to 67 months), Ninety nine (95%) of the patients were in N YHA class I, 6 (5%) in class II, No late complications were noted, We conclude that, complete myocardial revascularization using the right g astroepiploic artery in combination with both internal thoracic arteri es as pedicled grafts can be achieved in selected patients with excell ent mid term results.