LOW RECURRENCE OF ANGINA-PECTORIS AFTER CORONARY-ARTERY BYPASS GRAFT-SURGERY WITH BILATERAL INTERNAL THORACIC AND RIGHT GASTROEPIPLOIC ARTERIES

Background-In the past 10 years, there has been a trend to use more ar terial grafts instead of vein grafts for coronary artery bypass graft surgery. Although there are many reports on the short-and mid-term fol low-up of patients who underwent arterial revascularization with 1 or 2 arteries, little has been reported on the follow-up of patients with 3-vessel disease who received 3 arteries. Methods and Results-We revi ewed a group of 256 patients with 3-vessel disease who received the ri ght gastroepiploic artery together with both internal thoracic arterie s (ITAs). Vein grafts were not used in these patients. The patients we re monitored for up to 7 years (mean, 51+/-15 months). Seven-year actu arial survival was 91.1%. The cumulative probability of event-free sur vival for myocardial infarction, reintervention, and angina pectoris a t 7 years was 97.3%, 95.4%, and 85.4%, respectively. Conclusions-We co nclude that concomitant use of the gastroepiploic artery with both ITA s results in low mortality and a low incidence of myocardial infarctio n and reintervention at follow-up. Most interestingly, we found 85.4% freedom from angina pectoris after 7 years, which is considerably lowe r than the results of studies in which vein grafts, single ITA grafts, or double ITA grafts are used. These results strongly support the use of both ITAs and the right gastroepiploic artery for bypass grafting in patients with 3-vessel disease.