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November 1967

An Improved Method of Myocardial Revascularization With a Vascular Implant

Arch Surg. 1967;95(5):724-735. doi:10.1001/archsurg.1967.01330170032005

THE internal mammary artery inserted into a myocardial tunnel has been shown to provide a significant new blood supply to the heart.1-5 When the operation is performed with the standard technique, however, the initial flow rates are very small and a significant incidence of implant thrombosis occurs.6-7 When the implant remains patent, anastomoses with the coronary arteries develop over the course of several months and the initially low flow rate increases to a substantial volume.6 Relief of intractible angina and the persistence of a patent implant have been reported in a gratifying percentage of patients offered this operation.2,4,5

The operation would be improved if higher initial flow rates were achieved. This would ensure continued patency, aid in the early development of significant implantcoronary anastomoses, and provide more significant extra supply of blood to the myocardium. In a series of experiments directed to this purpose, we have