Hayashi S, Kawaue Y, Sueshiro M, Kado S, Ono Y
Department of Cardiovascular Surgery, Hiroshima General Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jan;42(1):105-9.
We experienced a rare case of the gastric cancer occurred after the coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA). On April, 1990, a 74-year-old woman underwent CABG using RGEA for angina pectoris due to 99% stenosis of the right coronary artery. Anorexia and vomiting appeared from December 1992. Examination of the stomach by an oral procedure led to a diagnosis of the pyloric stenosis due to the gastric cancer. The coronary arterial lesion was progressive, and 90% stenosis of LAD (#6, #7) was noted. On February 1993, the re-CABG and the gastrectomy were performed simultaneously. The re-CABG using the saphenous vein was performed to #3, and additional CABG using the bilateral internal thoracic artery were performed to #8 and #9. At the same time, the gastrectomy were performed and RGEA was resected to remove the R2 lymph node completely. If the root of RGEA had been exposed completely at the first operation, RGEA could be preserved as the bypass graft.
