A Case of Hepatectomy after Coronary Artery Bypass Grafting Using the Right Gastroepiploic Artery

Abstract

A 78-year-old man in whom coronary artery bypass grafting (CABG) was performed with the left internal thoracic artery, saphenous vein, and right gastroepiploic artery (RGEA) in 2001 was admitted with hepatocellular carcinoma in February 2013. We performed a posterior segmentectomy. The RGEA was surrounded by a hard lesions ; however, thoracolaparotomy provided us a fine surgical view and allowed us to easily perform the surgery without synechiotomy around the RGEA. The problem with an epigastric operation after CABG using the RGEA is the risk of cardiogenic shock secondary to graft injury and spasm caused by mechanical stimuli. We believe that preoperative assessment of the cardiac function and condition of the RGEA graft, and the skills required to perform the surgery should be carefully considered.