A New Concept to Restore the Failing Enlarged Ischemic Heart

Preliminary Report

¹ Royal Victoria Hospital, Montreal, Quebec, Cannada

Certain failing enlarged ischemic hearts are difficult to treat by mammary implants, epicardiectomy, omental grafts. A new concept and operation has been experimentally tested, based upon the omental graft's ability to form arteriolar communications with surrounding arteries within eight days. In animals, three coronary arteries were surrounded by ameroid constrictors. Three separate omental strip grafts containing large blood vessels were sutured to the aorta and over each coronary artery. All control animals died within 18 days. Seventy-two percent treated animals which survived Schlesinger mass injections three to seven months, demonstrated anastomoses between periaortic coronary and omental strip vessels. These bypassed ameroid and other points of constriction in coronary arteries. New omental vessels were confirmed by histologic sections. Cutting of omental grafts months postoperatively in living animals caused extensive bleeding. Development of multiple vessels bypassing points of coronary artery obstruction has been achieved. The procedure is applicable to peripheral vascular small vessel disease. The course of one treated patient is reported.