Interval Results with Right Gastroepiploic Bypass


  • Thomas Z. Lajos
  • Mohammed Akhter
  • Jacob Bergsland
  • Syed T. Raza



Objective: Right gastroepiploic artery bypass grafting has proved to be a viable surgical choice since the mid-1980s. Long-term graft patency, however, has been challenged ever since. We present 43 patients who underwent right gastroepiploic artery bypass surgery off pump with minimal invasive techniques with an average follow-up period of 57.9 months since 1996.

Methods: Operative methods are described and were confined to a subxiphoid incision. The series consists of 43 patients (38 male and 5 female) with an age range of 44 to 79 years. All patients had heart disease classified as Canadian Cardiovascular Society class III-IV and 35/43 (81.3%) of patients had undergone 1 to 3 reoperations. Postoperatively, 93% had no complications. Crude mortality was 2.3%, with an expected mortality of 4% and risk-adjusted mortality of 1.45%. Nine patients underwent combined procedures.

Results: Of the 43 patients, 41 were alive at 57.4 months (range, 20-76 months). Results of Doppler studies and angiography proved 95.3% and 91.6% patency.

Conclusion: In this series, our highest-risk patients with reoperative coronary artery disease had low mortality and no intervention in this interval follow-up.


Akhter M, Lajos, T, Grosner G, Bergsland J, Salerno T. 1997. Reoperations with the right gastroepiploic artery without cardiopulmonary bypass. J Card Surg 12:210-4.nD'Ancona G, Karamanoukian HL, Salerno TA, Schmid S, Bergsland J. 1999. Flow measurement in coronary surgery. Heart Surg Forum 2:121-4.nFonger JD, Doty JR, Salazar JD, Walinsky PL, Salomon NW. 1999. Initial experience with MIDCAB grafting using the gastroepiploic artery. Ann Thorac Surg 68:431-6.nLajos TZ. 2001. Off-pump reoperations using the right gastroepiploic artery. In: Salerno, Tomas; Ricci, Marco; Bergsland, Jacob; Karamanoukian, Hratch, editors. Beating heart coronary artery surgery. New York: Furtura Publishing Company. p 143.nNakao T, Kawaue Y. 1993. Effect of coronary revascularization with the right gastroepiploic artery. J Thorac Cardiovasc Surg 106:149-53.nOchi M, Hatori N, Fujii M, Saji Y, Tanaka S, Honma H. 2001. Limited flow capacity of the right gastroepiploic artery graft: postoperative echocardiographic and angiographic evaluation. Ann Thorac Surg 71:1210-4.nOchi M, Bessho R, Saji Y, Fujii M, Hatori N, Tanaka S. 2001. Sequential grafting of the right gastroepiploic artery in coronary artery bypass surgery. Ann Thorac Surg 71:1205-9.nPym J, Brown PM, Charette EJP, et al. 1987. Gastroepiploic coronary anastomosis. A viable alternative bypass graft. J Thorac Cardiovasc Surg 94:256-9.nRobicsek F, Svenson R, Hickllin H. 1993. Does competing flow decrease the efficiency of internal mammary grafts [letter]? J Card Surg 8:435-6.nSuma H, Fukumoto H, Takeuchi A. 1987. Coronary artery bypass grafting by utilizing in situ right gastroepilpoic artery. Basic study and clinical application. Ann Thorac Surg 44:394-7.nSuma H, Isomura T, Horii T, Sato T. 2000. Late angiographic result of using the right gastroepiploic artery as a graft. J Thorac Cardiovasc Surg 120:496-8.nTavilla G, Jackimovicz J, Berreklouw E. 1997. Intraoperative blood flow measurement of the right gastroepiploic artery using pulsed doppler echocardiography. Ann Thorac Surg 64:426-31.nVoutilainen S, Verkkala S, Jarvinen A, et al. 1998. Minimally invasive coronary artery bypass grafting using the right gastroepiploic artery. Ann Thorac Surg 65:444-8.n



How to Cite

Lajos, T. Z., Akhter, M., Bergsland, J., & Raza, S. T. (2005). Interval Results with Right Gastroepiploic Bypass. The Heart Surgery Forum, 6(6), E99-E102.




Most read articles by the same author(s)