En-Bloc Free Gastroepiploic Artery Graft Provides a Good Long-Term Patency Rate

For coronary artery bypass grafting, the use of free gastroepiploic artery is unpopular because of its tendency to vasospasm. We assessed the en-bloc free gastroepiploic artery graft, which has the gastroepiploic vein anastomosed to the right atrial appendage to prevent graft spasm, and compared it to the skeletonized free gastroepiploic artery graft. A retrospective review was conducted in 57 patients who received en-bloc grafts and 29 who had skeletonized grafts. Kaplan-Meier analysis demonstrated the superiority of the en-bloc free gastroepiploic artery graft with an 80-month patency rate of 96.6% compared to 66.7% with skeletonized grafts. We selected 13 cases from each group, using propensity-score matching, and compared the long-term patency rates. Propensity-score matched analysis showed 80-month patency rates of 100% for en-bloc grafts and 60% for skeletonized grafts. Coronary artery bypass using free gastroepiploic artery grafts with venous drainage seems to provide good long-term results.