Graft selection for the right coronary artery territory in off-pump coronary artery bypass

BackgroundThe ideal bypass conduit in a right coronary artery (RCA) system remains controversial. MethodsWe analyzed 121 patients who underwent off-pump coronary artery bypass with internal thoracic arteries for the left coronary artery system and either in situ a right gastroepiploic artery (RGEA; n=66) or a saphenous vein graft (SVG; n=55) for the RCA system were enrolled. Follow-up coronary computed tomographic angiographic data were reviewed. ResultsThe RGEA group showed higher graft patency at 5 years, especially in high grade stenosis (80%; p=0.009). In the SVG group, no difference was found between high grade stenosis and low grade stenosis. Freedom from adverse cardiac events at 5 years was higher in the RGEA group (p=0.006). On multivariate analysis, low grade stenosis of RCA was predictive of graft failure (p=0.029, hazard ratio=10.9). ConclusionsIn high grade stenosis of RCA, the RGEA group showed higher patency rate. The patency rate of SVG was not dependent on the degree of stenosis of RCA.