Back to 2014 Annual Meeting Posters

OBJECTIVE: In OPCAB, aorta no touch strategy is employed to reduce operative complication and in situ right gastroepiploic artery (RGEA) would be useful graft to accomplish this strategy. In this study, we evaluated the result of in situ GEA used in CABG.
METHODS: From January 2000 to December 2005, 543 consecutive patients underwent isolated CABG with full sternotomy. Of these, we retrospectively reviewed 305 patients who underwent CABG with in situ GEA harvested in semi-skeletonize fashion.
RESULTS: The average age was 64.3±8.5 years, and 242 patients were male. 267 patients received elective surgery and 6 patients had previous cardiac surgery. 153 patients had diabetes mellitus and 23 patients had hemodialysis. There were 79 OPCAB, 39 on pump beating CABG, 187 conventional CABG. The average number of anastomosis was 3.5±1.1. Single ITA was used in 92 cases, and bilateral ITA was used in 204 cases. 290 patient received CABG with all arterial graft. Postoperative complication included 2 pneumonia, 6 stroke, and 10 mediastinitis. 30-day mortality was 2 (0.66%). The survival rate and the cardiac death free rate at 1, 5, 10 years were 97.2%, 94.0% 79.8% and 99.3%, 98.4%, 97.3%, respectively. A total 409 GEA anastomoses included 344 RCA anastomoses, 64 circumflex anastomoses and 93 sequential anastomoses. There were 11 early occlusions (2.7%). The cumulative patency rate of the GEA at 1, 5, 10 years were 94.8%, 83.7%, 75.1%, respectively. The cumulative patency rate of the GEA to RCA and circumflex at 10 years were 75.1% and 82.4%, which was not significant (log-rank p=0.75). Multivariate Cox proportional hazard regression analysis showed severe target vessel stenosis as the only risk factor for late GEA occlusion.
(HR 1.85, 95%CI 0.19-0.92, p=0.031)
CONCLUSIONS: The patency rate of GEA graft in semi-skeletonize fashion was excellent. This result would promote aorta no touch CABG with all arterial graft.