Persistence of New Vascular Channels Following Cardiopexy

Necropsy Demonstration of Extracardiac Blood Supply 15 Months and 11 Years After Operation

¹ Edgewater Hospital

The surgical procedure of cardiopexy has developed to the point where, in properly selected cases, the risk is very small. In our series at the Edgewater Hospital, 187 such operations have been performed in the last 15 years with a total surgical mortality of 3 per cent. In the last 10 years, 138 operations have been done with only two surgical deaths. When you consider the cases that present themselves to us for surgery, with severe coronary disease, multiple infarctions, severe coronary occlusions, the results are excellent. We should consider therefore the operation from the standpoint of its possible value rather than its risk.

On the basis of two cases in which an adequate blood supply was maintained for 15 months and 11 years, we cannot say that every patient will be so protected. However of 187 patients operated on in these past 15 years, 143 are still alive. All of these had the same indications—previous myocardial infarcts and definite evidence of coronary insufficiency. It is not too unwarranted a conclusion that some degree of protection was afforded to most of these people although their coronary disease continued to progress. Therefore, we maintain that good medical management, i.e., weight control, low-fat, low-cholesterol diet, appropriate drugs and anti-coagulants where indicated, and a moderate exercise program supplemented by cardiopexy will give better results and protection in preventing ventricular fibrillation than medical management alone.

Simple arithmetic creates an interesting conclusion. If we add the minimal risk of the operation to the demonstrated possibility that a newly created blood supply may remain functioning for years, the result is a reasonable chance of improvement for a reasonable period of time. There is hope, therefore, that the tragic end of the second case may be prevented in similar cases by surgical intervention before the major occlusion.