Off-Pump Coronary Artery Bypass Using Skeletonized Gastroepiploic Artery, a Pilot Study

Authors

  • Atsushi Amano
  • Ruzheng Li
  • Hitoshi Hirose

DOI:

https://doi.org/10.1532/hsf.549

Abstract

Background: The problem with using the gastroepiploic artery (GEA) for coronary artery bypass grafting (CABG) is vasospasm. To minimize vasospasm of the GEA, a skeletonized harvesting technique was used for GEA harvesting. We present the initial results of GEA grafting using this technique. Methods: Between September 1, 2002, and December 31, 2002, a total of 25 patients (21 men and 4 women, mean age 65.4 ± 8.7 years) gave informed consent and underwent elective off-pump CABG using the skeletonized GEA. Skeletonization was completed using an ultrasonic scalpel (Harmonic scalpel, coagulating-scissors; Ethicon Endo-Surgery, Cincinnati, OH, USA). Follow-up data were available until August 31, 2003. Perioperative, early clinical, and follow-up results were analyzed. Results: There were no hospital deaths, perioperative myocardial infarctions, congestive heart failure, strokes, or renal failure. There were no abdominal complications. Follow-up data were available from all patients, with a mean follow-up of 0.8 ± 0.1 years. There were no cardiac deaths or cardiac events. Conclusion: During our limited follow-up period, the early results of skeletonized GEA grafting were excellent, and cardiac events have been well controlled. Mid-term follow-up study and angiographic study are necessary to confirm our initial clinical outcome data.

References

Hashimoto H, Isshiki T Ikari Y, et al. 1996. Effects of competitive blood flow on arterial raft patency and diameter. Medium-term postoperative follow-up. J Thorac Cardiovasc Surg 111:399-407.nHirose H, Amano A, Takanashi S, et al. 2002. Coronary artery bypass grafting using the gastroepiploic artery: 1000 cases. Ann Thorac Surg 73:1371-9.nHirose H, Amano A, Takahashi A. 2002. Off-pump coronary artery bypass grafting for patients with three-vessel disease. Surgery 132:57-65.nSuma H, Isomura T, Horii T, et al. 2000. Late angiographic result of using the right gastroepiploic artery as a graft. J Thorac Cardiovasc Surg 120:496-8.nUchida N, Kawaue Y. 1996. Flow competition of the right gastroepiploic artery graft in coronary revascularization. Ann Thorac Surg 62:1342-6.nUeda T Taniguchi S, Kawata T et al. 2003. Does skeletonization compromise the integrity of internal thoracic artery grafts? Ann Thorac Surg 75:1429-33.nAmano A, Takahashi A, Takanashi S, et al. 2002. Skeletonized radial artery grafting; improved angiographic results. Ann Thorac Surg 73:1880-7.nAsai T Tabata S. 2002. Skeletonization of the right gastroepiploic artery using an ultrasonic scalpel. Ann Thorac Surg 74:1715-7.nChoi JB, Lee SY. 1996. Skeletonized and pedicled internal thoracic artery grafts: effect on free flow during bypass. Ann Thorac Surg 61:909-13.nGagliardotto P Coste P Lazreg M, et al. 1998. Skeletonized right gastroepiploic artery used for coronary artery bypass grafting. Ann Thorac Surg 66:240-2.nWendler O, Tscholl D, Huang Q, et al. 1999. Free flow capacity of skeletonized versus pedicled internal mammary artery grafts in coronary artery bypass grafts. Euro J Cardiothorac Surg 15:247-50.n

Published

2005-01-04

How to Cite

Amano, A., Li, R., & Hirose, H. (2005). Off-Pump Coronary Artery Bypass Using Skeletonized Gastroepiploic Artery, a Pilot Study. The Heart Surgery Forum, 7(1), E101-E104. https://doi.org/10.1532/hsf.549

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