Abstract 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 References 1. Gardner, R.J., and Glass, D.D.: Relief of Posterior Myocardial Ischemia by Splenic Artery Implantation , Thorac Cardiov Surg 54:867-875 ( (Dev) ) 1967. 2. Bailey, C.P., et al: Revascularization of the Posterior (Diaphragmatic) Portion of the Heart , Ann Thorac Surg 2:791, 1966.Crossref 3. Pearce, C.W., et al: Myocardial Revascularization: Implantation of Intercostal Artery , Thorac Cardiov Surg 52:809-812 ( (Dec) ) 1966. 4. Beck, C.S.: Coronary Artery Disease-Physiologic Concepts—Surgical Operation , Ann Surg 145:439-460, ( (April) ) 1957.Crossref 5. Vineberg, A.M., and Mahanti, B.: Evaluation of Experimental Myocardial Revascularization Operations by Ameroid Coronary Artery Constriction , Surgery 47:748-764 ( (May) ) 1960. 6. Lary, B.G., et al: The "Coronary Myocardial Artery" for Coronary Artery Disease , Dis Chest 49:412-419 ( (April) ) 1966.Crossref 7. Lary, B.G.: An Epicardial Purse String Suture for Closing Coronary Arteriotomy , Amer Surg 33:213-214 ( (March) ) 1967. 8. Lary, B.G.: Onlay Vein Graft for the Correction of Coronary Artery Obstruction , Surgery 59:547-551 ( (April) ) 1966.
Archives of Surgery – American Medical Association
Published: Jan 1, 1969