Off-Pump Coronary Artery Bypass Using Skeletonized Gastroepiploic Artery, a Pilot Study. 2004

Atsushi Amano, and Ruzheng Li, and Hitoshi Hirose
Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.

Abstract Background: The problem with using the gastroepiploic artery (GEA)for coronary artery bypass grafting (CABG) is vasospasm. To minimize vasospasm of the GEA, a skeletonized harvesting technique was used for GEA harvesting. We present the initial results of GEA grafting using this technique. Methods: Between September 1, 2002, and December 31, 2002, a total of 25 patients (21 men and 4 women, mean age 65.4 +/- 8.7 years) gave informed consent and underwent elective off-pump CABG using the skeletonized GEA. Skeletonization was completed using an ultrasonic scalpel (Harmonic scalpel, coagulating-scissors; Ethicon Endo-Surgery, Cincinnati, OH, USA). Follow-up data were available until August 31, 2003. Perioperative, early clinical, and follow-up results were analyzed. Results: There were no hospital deaths, perioperative myocardial infarctions, congestive heart failure, strokes, or renal failure. There were no abdominal complications. Follow-up data were available from all patients, with a mean follow-up of 0.8 +/- 0.1 years. There were no cardiac deaths or cardiac events. Conclusion: During our limited follow-up period, the early results of skeletonized GEA grafting were excellent, and cardiac events have been well controlled. Mid-term follow-up study and angiographic study are necessary to confirm our initial clinical outcome data.

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