Coronary artery bypass grafting with the right gastroepiploic artery and evaluation of flow with transcutaneous Doppler echocardiography.

From December 1988 to December 1992, 174 patients (160 men, 14 women, mean age 59.7 years, range 38 to 79 years) underwent coronary artery bypass grafting with the right gastroepiploic artery. The graft was anastomosed to the right coronary artery (n = 137), the circumflex artery (n = 18), the left anterior descending artery (n = 23), and the diagonal artery (n = 1). Three early deaths (1.7%) and one late death (0.6%) occurred. Graft patency and flow were evaluated noninvasively in 44 of the patients, selected at random between 1990 and 1993. They underwent transcutaneous Doppler echocardiographically to detect postoperative gastroepiploic artery flow. The patients were divided into two groups on the basis of the angiographic study: group I, good patency (n = 38); group II, poor flow in the graft or more than 75% stenosis of the anastomosis (n = 6). Biphasic Doppler flow signals were identified in 39 patients (88.6%) (group I, 35/38; group II, 4/6). The ratio of diastolic to total flow measured by time-velocity integral was 0.68 +/- 0.07 in group I and 0.32 +/- 0.09 in group II (p < 0.001). We conclude that the right gastroepiploic artery is an effective graft and that Doppler echocardiography may be a useful tool to noninvasively evaluate the patency and flow of the gastroepiploic artery graft as a coronary artery graft.