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November 29, 1965

Three-Step Operation Revascularizes Entire Heart

JAMA. 1965;194(9):29-34. doi:10.1001/jama.1965.03090220103053

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A three-step operation which revascularizes the entire heart has been used successfully in patients with severe coronary artery disease.

The procedure, which combines internal mammary artery implantation, epicardiectomy, and the free omental graft operations, was described at the American Heart Association Scientific Session at Bal Harbour, Fla, by Arthur M. Vineberg, MD, Montreal, Canada.

Internal mammary artery implantation coupled with epicardiectomy has been used by Dr. Vineberg and others for more than a decade in treating patients with coronary artery disease.

Internal mammary artery implantation, developed by Dr. Vineberg some 15 years ago, introduces the left internal mammary artery into the anterior wall of the left ventricle where it supplies oxygenated blood to the anterior descending arteriolar zone of the heart—but not to the posterior zone.

In order to have this blood reach the posterior wall of the left ventricle, it was necessary to do an epicardiectomy.

"Epicardiectomy stimulates the

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