Renewed interest in surgery for coronary artery disease has increased research efforts in this field.1-3 New techniques are required to explore ideas which may result in simpler operations that will have wider clinical application. In the indirect surgical approach to coronary artery disease, the epicardium has been intentionally destroyed by acid4 and abrasion5 to permit the ingrowth of new blood vessels. Work with the direct approach has demonstrated that the epicardium is an extremely valuable tissue which makes it possible to explore a number of experimental ideas for myocardial vascularization. It has, for example, been shown that a vein can be sutured to the epicardium to enlarge the lumen of a coronary artery,6 and it can be used to effectively tamponade a coronary arteriotomy.7
It is the purpose of this paper to demonstrate the value of the epicardium, and to report findings with further attempts