EARLY EXPERIENCE WITH THE INFERIOR EPIGASTRIC ARTERY IN CORONARY-ARTERY BYPASS-GRAFTING - A WORD OF CAUTION

The excellent results with the internal thoracic artery for coronary a rtery bypass grafting have prompted the search for other arterial cond uits. From November 1991 to February 1992, 18 patients underwent coron ary artery bypass grafting with the use of inferior epigastric artery grafts. Patients' ages averaged 52 +/- 9 years. Bilateral internal tho racic artery grafts were used in 17 patients (17/18, 94%) and a free g raft with one inferior epigastric artery was used in each patient. The inferior epigastric artery grafts were anastomosed to the right coron ary artery (n = 9), a marginal circumflex artery (n = 4), and to a dia gonal artery (n = 5). Three patients had abdominal wound complication related to harvesting of the inferior epigastric artery. Immediate pos toperative angiographic evaluation of inferior epigastric artery graft s showed that eight grafts were patent (8/14, 57%). Four of the occlud ed inferior epigastric arteries were grafted to the right coronary art ery and one to the second marginal circumflex coronary artery. Because of the low patency rate of inferior epigastric artery grafts, a word of caution is necessary in the selection of patients. At the present t ime, the inferior epigastric artery appears to be an interesting alter native only in patients who have no other available conduits.