Introduction: In cardiac surgery, it is commonlyaccepted that arterial conduits are superior to venous or artificial grafts in aorta-coronary bypass operations due to long-term patency. In multiple coronary artery disease and in cases where revascularisation is required the internal mammary artery (IMA) which have been the most widely used arterial greft has been insufficient and other graft or grafts are needed. In our study right gastroepiploic artery (RGEA) which is an insitu graft and is similar to İMA by histological structure and endothelial functions is used as a third graft. Methods: In the 19 cases in our study RGEA in addition to bilateral IMA as an arterial graft has been used. The cases in which preoperative triple coronary artery disease has been detected, had an average age of 49,1 (31-65) and of the cases 15 were men while the four were women. Results: Total anastomoses number was 82 (4.42/per case). RGEA was anastomosed to RDP in 13 case, to RCA in 3 cases to Plcx in 2 case and to Plcx and OM sequentially in one case. In one case, anasthomos is was revised due to the ECG changes that was observed. After revised the ECG changes recovered. There were no other peroperative problems. One case was lost in the 6th postoperative day due to non-cardiac reasons. There were no other complications. Discussion: In cases where the proximal lesion of coronary artery disease was above 70 %, and anastomoses was as paralel as possible to the coronary flow and utmost care was given to the anatomic position, RGEA in addition to full arterial revascularisation was performed without any problems. We therefore think that in cases where IMA’s are insufficient RGEA’s though long term results have to be observed, can be an alternative conduit if no obstacle is present.

Keywords :