Direct coronary artery surgery for coronary artery occlusive disease

Surgical revascularization of the myocardium for coronary artery occlusive disease has gained great impetus over the past five years with the advent of successful methods of direct surgical reconstruction of the coronary arteries. Seventy-five patients underwent direct coronary artery surgery for ischemic heart disease over the past two and a half years. The indication for coronary arterial revascularization was angina in forty-eight patients, congestive heart failure in twenty-four patients, and recurrent myocardial infarction in three patients. In this group of seventy-five patients there were 105 aortocoronary saphenous vein bypass grafts, five internal mammary-coronary artery bypass grafts, and thirty-five distal endarterectomies combined with aortocoronary vein bypass grafts. Direct coronary artery surgery was combined with resection of a left ventricular aneurysm in seven patients and with aortic valve replacement in three. A single coronary artery was reconstructed in twenty-seven cases and two of the three major coronary arteries were reconstructed in thirty-nine cases.