ROLE OF GASTROEPIPLOIC AND EPIGASTRIC ART ERIES IN MYOCARDIAL REVASCULARIZATION SURGERY

Seventy patients underwent coronary artery bypass grafting with the ri ght gastroepiploic artery or the inferior epigastric artery between 19 89 and 1992 at the Montreal Heart Institute. There were 68 men and 2 w omen with a mean age of 53 +/- 8 years, the right gastroepiploic arter y in situ was anastomosed to the right coronary artery in 55 patients and the inferior epigastric artery (free graft) was used in 18 patient s. Double internal thoracic artery grafts were used in all patients. E arly patency rate of right gastroepiploic artery and inferior epigastr ic artery grafts was 91 % (31/34 grafts) and 57 % (8/14 grafts) respec tively. One patient died after surgery (1,4 %) from acute renal failur e and one patient developed an acute myocardial infarction (1,4 %) at surgery. Fifty-five patients (55/57, 96 %) showed no evidence of angin a at the last follow-up. In conclusion, patency rate and clinical resu lts of coronary artery bypass grafting with the right gastroepiploic a rtery graft were excellent and patency rate of inferior epigastric art ery graft was unsatisfactory. We suggest that epigastric artery grafts should be used with caution, only when no other alternative is availa ble.