Revascularization via healthy myocardial arteriolar networks compared with that through diseased surface coronary arteries.

Myocardial mammary artery implants revascularize via the undiseased coronary microcirculation. Such implants, followed for up to 20 years, showed no atherosclerosis, while the coronary arteries of the patients became totally occluded. Implant patency with collateralization was 80%; some patients were living entirely on blood supplied by mammary implants. Operative mortality was 2%. There was improvement in anginal pain in 85% of the cases and in left ventricular failure, in 67%. Studies of 43 patients with single implants, followed for up to 20 years, showed that 54% survived for an average of eight years and 46% have survived for an average of 12 years, and are still living. Double-ventricular implants in 42 patients with triple coronary artery disease showed that 90.5% survived for an average of five years, compared with 53% for medically treated patients. The technique of mammary implants is described and the procedure is compared to aortocoronary bypass grafts.