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February 28, 1966

Revascularization of the Heart

JAMA. 1966;195(9):29-33. doi:10.1001/jama.1966.03100090019007

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Revascularizationrt represents a surgical attempt to circumvent the ischemic effects of atherosclerosis by supplying blood to the myocardium via channels that supplement, or substitute for, the coronary arteries.

The procedure is based upon the fact that coronary artery disease, although a diffuse process, usually is confined to the epicardial segment of the artery; the arterioles buried in the myocardium often remain free of disease.

Many surgical procedures have been developed to augment the reduced blood flow through the diseased coronary arteries by connecting this intact distribution network to a new blood source.

Perhaps the most successful has been the Vineberg operation. In this procedure, the left internal mammary artery is mobilized and implanted within a tunnel in the left ventricular wall.

Since, however, the entire heart cannot be revascularized by this method, Dr. Vineberg and other investigators have developed several supplementary procedures to extend revascularization to other areas of the

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