Korean J Thorac Cardiovasc Surg.
1999 Oct;32(10):883-890.
Histological Characteristics of Right Gastroepiploic Artery for
Coronary Artery Bypass Graft
- Affiliations
-
- 1Department of Thoracic & Cardiovascular Surgery, Asan Medical Center,
College of Medicine, Ulsan University.
Abstract
-
BACKGROUND: Long term patency of arterial graft has been better than venous graft and redo coronary
artery bypass grafting has been increasing, therefore, there has been an increasing need
for alternative arterial grafts except internal thoracic artery(ITA).
MATERIAL AND METHOD: Right gastroepiploic arteries(RGEA) were harvested from 100 patients
who had received gastrectomy for gastric cancer or ulcer. ITAs were obtained from 10 patients
undergoing coronary artery bypass grafting. The length of RGEA was measured from the pyloric
ring. Items of the morphometric and histologic study at the pyloric ring and sites of
the 10cm and 20cm RGEA from the pyloric ring were luminal diameter, intimal thickness,
medial thickness, wall thickness, degree of intimal hyperplasia, intimal thickness, medial
thickness, wall thickness, degree of intimal hyperplasia, intimal thickness index, medial
thickness index, and the number of discontinuities of the internal elastic lamina. Similar
items were applied to the proximal site of ITAs.
RESULT: The length of RGEA was 23+/-2.7cm(range 17~31cm). Comparing the 20cm RGEA with ITA,
intimal thickness, medial thickness, wall thickness, and degree of intimal hyperplasia did
not show any difference(p>0.05). However, 20cm RGEA was greater than ITA at the luminal
diameter, intimal thickness index, and the number thickness and wall thickness in each site
of the RGEA(pyloric ring, 10cm, 20cm) decreased from the pyloric ring to the distal
sites(p<0.05). The degree of intimal hyperplasia and the number of discontinuities
of the internal elastic lamina did not show any difference between the pyloric ring and 10cm,
however, those of 20cm were smaller than these sites(p<0.05). RGEA had more number of
discontinuities of the internal elastic lamina and rich smooth muscle cells in the media
than ITA.
CONCLUSION
The length and diameter of RGEA is good enough to reach most of the coronary
arteries. Moreover, long term patency of RGEA may be improved, if anastomosed in the distal site.