INFERIOR EPIGASTRIC ARTERY AS A CONDUIT FOR MYOCARDIAL REVASCULARIZATION

In 18 patients the inferior epigastric artery (IEA) was used for myoca rdial revascularization along with the left internal mammary artery an d saphenous vein (4.5 grafts/patient). Preoperative duplex scan assess ment of IEA correctly predicted its distal diameter. At operation the mean internal diameter was 1.6 (1.5-2.0) mm distally and 2.1 (2.0-2.5) mm proximally. The mean in situ flow after intraluminal injection of papaverine was 115 (36-210) ml/min in IEA and 136 (56-210)ml/min in in ternal mammary artery. There was no perioperative death or myocardial infarction. Morbidity associated with IEA harvesting was minor: ultras onography showed diastasis and slower contraction of the rectus muscle at the harvesting site than contralaterally in one case. The preopera tive duplex scan was useful for evaluating IEA size. All the patients were clinically improved. The patency rate at selective IEA angiograph y 3 months postoperatively was 72% (13/18). This poor early patency of IEA in our small series raises doubts concerning the vessel's suitabi lity for myocardial revascularization.