Wellens F, Vanermen H, De Geest R, Goldstein J
Dept. Cardiovascular Surgery, O. L. Vrouwziekenhuis, Aalst.
Acta Chir Belg. 1991 Jan-Feb;91(1):54-8.
The initial experience in 18 patients undergoing coronary artery bypass surgery with the right gastroepiploic artery (RGEA) between April 1988 and August 1989 is reported. The indication for RGEA-use included the aim to obtain complete arterial revascularization in 15 patients and absence of suitable veins in 3 patients. Twelve patients had at least one previous CABG-operation. The average number of distal arterial anastomoses per patient was 2.5. The RGEA was connected to the right coronary artery (RCA) or its terminal branches in 13 patients, to the circumflex (CX) in 2 and sequentially to RCA and CX in 3 patients. In combination to the RGEA, 8 patients received bilateral internal mammary grafts and 6 patients received a single IMA-graft. There was one hospital death and there were no major early or late complications related to the RGEA-use. Postoperative angiographic controls in 16 patients revealed only one early RGEA-graft occlusion due to inadequate diameter and low run-off. There was one demonstrated late occlusion. These early results suggest that the RGEA can be used as an in situ graft to the posterior coronary vessels. Indications can be extended in function of the longterm patency and functional results.
本文报告了1988年4月至1989年8月期间18例接受右胃网膜动脉（RGEA）冠状动脉搭桥手术患者的初步经验。使用RGEA的指征包括15例患者旨在实现完全动脉血运重建，以及3例患者没有合适的静脉。12例患者此前至少接受过一次冠状动脉搭桥手术。每位患者远端动脉吻合的平均数量为2.5个。13例患者中，RGEA与右冠状动脉（RCA）或其终末分支相连，2例与回旋支（CX）相连，3例依次与RCA和CX相连。除RGEA外，8例患者接受了双侧乳内动脉移植，6例患者接受了单支乳内动脉移植。有1例医院死亡，未出现与使用RGEA相关的重大早期或晚期并发症。16例患者术后血管造影检查显示，仅1例因直径不足和血流灌注低出现早期RGEA移植血管闭塞。有1例出现晚期闭塞。这些早期结果表明，RGEA可作为冠状动脉后支血管的原位移植血管。根据长期通畅情况和功能结果，适应证可进一步扩大。
