SURGICAL procedures designed to give collateral circulation to diseased coronary arteries have been under investigation for several decades. The development of an internal mammary-artery implant by Vineberg1 marked a dramatic advance in the treatment of coronary artery disease, though acceptance was delayed until Sones and Shirey2 demonstrated good coronary artery filling through collateral channels from an internal mammary-artery implant. Since then, more surgeons have adopted this procedure, and the operation has received extended clinical application.
This communication concerns a modification of the procedure which appears promising on the basis of a series of experimental studies. In this technique, an aortomyocardial autogenous vein-graft is created by anastomosing an autogenous vein from the aorta to a tunnel in the left ventricular myocardium in a manner similar to the Vineberg operation.
In comparison with the mammary-artery implant, the vein-graft offers the following advantages: (1) the wider lumen of the vessel provides