Pedicled Omentum versus Free Omental Graft for Myocardial Revascularization

¹ Attending Surgeon; Chief, Gastric and Mixed Tumor Service, Associate Director of Surgical Research, Memorial Hospital for Cancer and Allied Diseases and the Sloan-Kettering Institute, New York City

The most frequently used method for myocardial revascularization today is by direct arterial implantation into the heart in conjunction with use of a free omental graft. The question that is raised is whether the pedicled omentum might not be a greater source of extra-cardiac blood than that supplied by the free omental graft. The intact omentum has been used in the past, but never received clinical acceptance apparently because of fear of causing postoperative gastric discomfort. Recent work on the technique of omental transposition now makes this likelihood quite remote. The pedicled omentum would appear to be superior to the free omentum for purposes of myocardial revascularization. The purpose of this paper is to bring this possibility into focus.