Revascularization of the Myocardium

¹ Department of Clinical Cardiology and the Department of Cardiovascular Disease and Cardiac Laboratory, The Cleveland Clinic Foundation, Cleveland, Ohio

The development of selective cine-coronary arteriography has made possible the selection of patients who have lesions that are anatomically favorable for surgical treatment of coronary arterial disease. It has been shown that favorable findings for internal mammary artery implantation operations are: at least 90 percent obstruction of a major coronary artery, evidence of collateral vessels supplying the portion of the artery distal to the obstructed area, and functioning myocardium in the region supplied by the obstructed artery. Localized severe obstructions of the right or left main coronary arteries can be treated directly by arteriotomy and patch-graft reconstruction or saphenous vein replacement of a segment of the artery. The identification of myocardial infarction postoperatively may present problems after vascularization operations. The operative mortality has been acceptable.