Right gastroepiploic artery graft for myocardial revascularization: prevalence of atherosclerosis and availability as a conduit.

Abstract

BACKGROUND:

We evaluated prevalence of atherosclerosis and availability of right gastroepiploic artery graft in patients undergoing coronary artery bypass graft surgery.

METHODS:

Among the 1,579 patients who underwent isolated coronary artery bypass grafting between January 1999 and December 2008, we opened the peritoneum to examine the right gastroepiploic artery for use as a graft in 1,128 patients (71.4%). A computer-based patient database system was utilized for this retrospective study.

RESULTS:

Of 1,128 patients, 139 patients (12.3%) had atherosclerotic right gastroepiploic arteries at gross examination. Seventy-three of 139 atherosclerotic right gastroepiploic arteries had multiple or diffuse atherosclerotic lesions that precluded their use as a bypass graft; the remaining 66 right gastroepiploic arteries were used as a bypass graft including the atheromatous segment or after exclusion of the atherosclerotic segment. Another 60 nonatherosclerotic right gastroepiploic arteries were unavailable to use as a graft because of their short length, small caliber, and weak pulsation. Overall availability of the right gastroepiploic arteries as a graft was 88.2% (995 of 1,128). Multivariable logistic regression analysis showed older age (≥65 years; p < 0.001), insulin-treated diabetes mellitus (p = 0.001), and chronic renal failure (p < 0.001) as independent risk factors for atherosclerosis.

CONCLUSIONS:

The prevalence of atherosclerosis and availability of the right gastroepiploic artery graft in patients undergoing isolated coronary artery bypass grafting was 12.3% and 88.2%, respectively. Older age (≥65 years), insulin-treated diabetes mellitus, and chronic renal failure were identified as independent predictors for the atherosclerotic right gastroepiploic artery.

• Authors: Kwang Ree Cho, Ho Young Hwang, Jun Sung Kim, Ki-Bong Kim
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 91 Issue 2 Pg. 440-3 (Feb 2011) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 21256286 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Comorbidity
• Coronary Artery Bypass (methods, statistics & numerical data)
• Coronary Artery Disease (epidemiology)
• Diabetes Mellitus, Type 1 (epidemiology)
• Female
• Gastroepiploic Artery (transplantation)
• Humans
• Kidney Failure, Chronic (epidemiology)
• Male
• Multivariate Analysis
• Prevalence
• Retrospective Studies
• Risk Factors
• Transplants (supply & distribution)
• Vascular Patency