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Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2023, Number 1

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Cir Card Mex 2023; 8 (1)

Radial and gastroepiploic arteries. Harvesting and utility

Camacho-Álvarez BB

Language: English
References: 15
Page: 12-16
PDF size: 162.95 Kb.


ABSTRACT

The radial artery graft in myocardial revascularization outperforms in survival, freedom from cardiovascular events/ death and patency to venous grafts. The myocardial revascularization guidelines consider it as the second arterial graft if the double breast is not possible. It requires clinical and sonographic evaluation; the exclusion criteria are clear. The technique for harvesting is very similar to that of the saphenous vein, preserving the brachioradialis nerve, recurrent radial nerve, and arterial interosseous branches. Pharmacological schemes for graft preservation depend on their availability. There are no studies that compare the proximal anastomosis site, which can be the ascending aorta or mammary arteries. The distal anastomoses can be single or sequential. The gastroepiploic artery graft is a little used graft whose reported effectiveness is similar to the rest of the arterial grafts in experienced centers, with no greater morbidity if harvested. It resembles the internal mammary artery, but with less long-term patency being up to 70 %. It is an alternative for multiple arterial revascularization with target vessels located in an accessible location to this graft and given the limited availability in number and quality of other grafts. The myocardial revascularization guidelines do not refer specifically to this graft. Criteria for its selection are clear. Harvesting requires extending the sternotomy to the abdomen and traversing the diaphragm with the graft. Anastomosis variants depend on the target vessel. Postoperative care is similar to that for other arterial grafts. Complications are related to distortion of the vessel.


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