Arterial Grafting for Myocardial Revascularization: Indications, Surgical Techniques and Results

Cardiovascular disease, the leading cause of With increased experience using the inter- death in industrialized societies, not only nal mammary artery, these groups of sur- strikes down a significant fraction of the geons eventually applied the procedure to a population without warning, but also causes larger population of patients. Eventually, prolonged suffering and disability in even the mammary artery was used in sequential larger number. Until the development of fashion to bypass more than one artery, and, heart surgery and the introduction of diag- in some patients, both mammary arteries nostic techniques including cineangiogra- were used. Using these new techniques, sur- phy, stress electrocardiography, echocardio- geons could bypass almost every area of the graphy, and myocardial scanning, the diseased coronary system except the distal treatment of arteriosclerotic heart disease circumflex branches and distal right branch- was confined to medical measures that were es. Then, in 1983 and in 1985, Campeau and usually only partially effective. Lytle published the results of their long-term After the introduction of selective coro- studies of mammary artery bypass. These nary angiography by Sones, surgeons, led by important reports showed significantly dif- Favaloro and Johnson, began to apply the ferent results in favor of the internal mam- principle of bypass to coronary arterial dis- mary artery over the saphenous vein graft. ease.