| Abstract: | Thirty consecutive patients with angina pectoris undergoing coronary artery bypass grafting using the proximally attached right gastro-epiploic artery are described. Posterior coronary arteries were grafted using the right gastro-epiploic artery, and grafts to the left coronary artery were done using predominantly internal mammary artery grafts. The right gastro-epiploic artery graft is mobilized along the greater curvature of the stomach, and transected distally. With cardiopulmonary bypass and blood cardioplegic arrest for myocardial preservation during cross-clamping of the aorta, the distal end of the artery is anastomosed end-to-side to the posterior descending artery or a postero-lateral branch, or to both, using a sequential technique. Twenty-five of the patients complained of symptoms suggestive of angina early postoperatively but are currently symptom-free with normal exercise tolerance. Thirteen patients had postoperative exercise tests: eight were normal, two were inconclusive, and three were abnormal. Nine grafted coronary arteries were re-angiogrammed, and seven were judged to be patent. It is concluded that, as an alternative resource, the right gastro-epiploic artery can be used to bypass coronary obstructions expeditiously and with results comparable to those obtained with the saphenous vein or internal mammary artery. |
