Eight years experience using the inferior epigastric artery for myocardial revascularization

• Published in: European journal of cardio-thoracic surgery 1997-02, Vol.11 (2), p.243-247
• Main Authors: PUIG, L. B, SOUSA, A. H. S, CIVIDANES, G. V. L, SOUTO, R. C. M, BITTENCOURT, A. H, OPPI, E. C, KOPEL, L, RAMIREZ, J. A. F
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angina Pectoris - diagnostic imaging; Angina Pectoris - surgery; Biological and medical sciences; Coronary Angiography; Coronary Disease - diagnostic imaging; Coronary Disease - surgery; Epigastric Arteries - transplantation; Female; Follow-Up Studies; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - surgery; Humans; Male; Medical sciences; Middle Aged; Myocardial Revascularization - methods; Postoperative Complications - diagnostic imaging; Postoperative Complications - surgery; Reoperation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(96)01054-8

We present the initial experience with the use of inferior epigastricartery as a free graft for myocardial revascularization in a series of 41patients operated on between 1987 and 1989 to show the clinical andangiographic results. Of the 41 patients, 29 were male, 12 female, withages ranging from 33 to 72 years, and weights from 50 to 86 kg. Theinferior epigastric artery grafts were predominantly employed to theanterior interventricular branch and diagonal branch. The proximalanastomosis into the aorta was done directly or with a patch of vein orpericardium. The 32 patients who survived had mean follow-up of 82 monthsand 22 are in functional class I, 8 in class II and 2 in class III ofangina. The early patency rate was: inferior epigastric artery- anteriorinterventricular branch, 85.7% and inferior epigastric artery- diagonalbranch. 85.7%. Sixteen patients underwent angiographic study at a meanfollow-up of 81.2 months and the patency rate to the anteriorinterventricular branch was 77.7% and to the diagonal branch was 100%.Three patients with early occluded inferior epigastric artery werereoperated on 3, 3 and 11 months after the operation. A filiform lumen ofthe graft and a small ostium in the aorta was found and explained theimperfection of the direct anastomosis due to unbalance thickness of thegraft and the aortic wall. Therefore it is occluded that the inferiorepigastric artery is an alternative arterial graft for myocardialrevascularization and that the use of a vein or pericardium patch can helpthe proximal anastomosis and improve potency of the graft.