MYOCARDIAL REVASCULARIZATION WITH THE GASTROEPIPLOIC ARTERY

Between July, 1990, and January, 1992, 21 consecutive patients underwe nt myocardial revascularization with the use of the right gastroepiplo ic artery, among other grafts. They were 20 men and 1 woman, with a me an age of fifty-five years (range: thirty-seven to seventy). Previous myocardial infarction was present in 44% of patients, unstable angina in 81%, and three-vessel disease in 75%. Mean ejection fraction was 54 % (range 45-67%). Two patients had had previous coronary bypass surger y. In 20 patients one or both internal mammary arteries or sequential grafts with the left internal mammary artery were used. Overall 63 cor onary grafts were performed (mean 3 grafts per patient). Of these, 81% were arterial grafts and 19% saphenous vein grafts. Gastroepiploical grafts were to the following branches: posterolateral branch, 3 patien ts; posterior descending artery, 11; right coronary artery, 6; and the left anterior descending artery, 1 patient. Mean aortic crossclamp ti me was seventy-four minutes. Mean total drainage was 1600 cc. The inci dence of perioperative acute myocardial infarction was 9.5%. Overall h ospital mortality was represented by 2 patients, 9.5%. Mortality in pr imary revascularization was represented by 1 patient, 5%.