Although other methods have been used in an attempt to revascularize the myocardium of a heart compromised by coronary arteriosclerosis, the procedure currently most popular and most widely used is the engraftment of a segment of autogenous saphenous vein between the aorta and a diseased coronary artery. The anatomical indication for the operation is segmental occlusion of a coronary artery at a proximal site and the absence of disease in the circulation normally fed by the occluded artery. When more than one major coronary artery is involved, multiple grafts have been affixed.
Berger and Stary1 assessed the anatomical feasibility of the operation in 300 hearts studied at autopsy. Obstructive lesions of the coronary arteries were generally proximal and multifocal. The authors found that the anatomy of coronary disease would have permitted the bypass procedure in a large percentage of the hearts they examined. Clinical conditions for substantiating the anatomical
Aortocoronary Bypass Operations. JAMA. 1973;223(7):795. doi:10.1001/jama.1973.03220070049013