INFERIOR EPIGASTRIC ARTERY AS A CONDUIT FOR MYOCARDIAL REVASCULARIZATION - A 2-YEAR CLINICAL AND ANGIOGRAPHIC FOLLOW-UP

The inferior epigastric artery has been proposed as a suitable conduit for myocardial revascularization but its mid-term patency rate has no t been assessed. A prospective clinical and angiographic study on the use of the inferior epigastric artery as an additional arterial condui t together with bilateral internal thoracic artery grafting was conduc ted in 38 patients, No deaths or major postoperative complications occ urred. Twenty-three patients underwent repeat angiography after an ave rage of 21.2 months. The left and right internal thoracic artery graft s patency rate was 95.6% (44/46), while inferior epigastric artery pat ency rate was 52.2% (12/23). By relating patency to the grafted corona ry branch, the following results were obtained: 100% for the left ante rior descending (3/3), right coronary (1/1) and ramus medianus (1/1): 40% (4/10) and 37.5% (3/8) for diagonals and obtuse marginals respecti vely. The low patency rates observed when the inferior epigastric arte ry is used on diagonals and obtuse marginals indicate that this vessel cannot be considered a suitable conduit for extensive application of arterial revascularization, We suggest that the inferior epigastric ar tery should only be used in patients presenting with contraindications to bilateral internal thoracic artery or right gastroepiploic artery grafting, or exhibiting unsuitable saphenous veins. (C) 1998 The Inter national Society for Cardiovascular Surgery. Published by Elsevier Sci ence Ltd. All rights reserved.