[Place of gastroepiploic and epigastric arteries in myocardial revascularization].

Seventy patients underwent coronary artery bypass grafting with the right gastroepiploic artery or the inferior epigastric artery between 1989 and 1992 at the Montreal Heart Institute. There were 68 men and 2 women with a mean age of 53 +/- 8 years, the right gastroepiploic artery in situ was anastomosed to the right coronary artery in 55 patients and the inferior epigastric artery (free graft) was used in 18 patients. Double internal thoracic artery grafts were used in all patients. Early patency rate of right gastroepiploic artery and inferior epigastric artery grafts was 91% (31/34 grafts) and 57% (8/14 grafts) respectively. One patient died after surgery (1.4%) from acute renal failure and one patient developed an acute myocardial infarction (1.4%) at surgery. Fifty-five patients (55/57, 96%) showed no evidence of angina at the last follow-up. In conclusion, patency rate and clinical results of coronary artery bypass grafting with the right gastroepiploic artery graft were excellent and patency rate of inferior epigastric artery graft was unsatisfactory. We suggest that epigastric artery grafts should be used with caution, only when no other alternative is available.