Optimal use of the gastroepiploic artery.

In 10 years' experience with the right gastroepiploic artery graft for myocardial revascularization, excellent clinical and angiographic mid-term results have been reported. From our experience in 518 patients who underwent CABG with a gastroepiploic artery graft since 1986, early and late mortality rates were 2.3% and 1.0%, respectively. Early and mid-term (2 to 5 years) angiographic patency rates were 96% and 92%, respectively, in the in situ gastroepiploic artery grafts. The gastroepiploic artery is the second best arterial conduit next to the internal thoracic artery at present, and is most useful at reoperation or for patients with atherosclerotic ascending aorta. With proper basic knowledge and surgical technique, the gastroepiploic artery can be used without increasing surgical mortality and morbidity, and good long-term patency can be expected.