[Initial clinical experiences with indirect myocardial revascularization--free skeletal muscle transplantation for induction of epimyocardial neovascularization].
Patients with multiple and peripherial coronary stenosis are not suitable for direct coronary artery surgery. For these patients a new surgical myocardial revascularization was developed. This new surgery was adopted on 5 patients from May 1993 through May 1995. The operation consisted in the grafting of a free skeletal muscle flap onto the anterior wall of the heart (musculus-latissimus-dorsi). The flap artery was implanted into the aorta, the venous flow was directed into the right atrium. All patients were about 3 weeks after the intervention free from angina. The postoperative bicycle ergometry showed no signs of ischemic ST-segment changes, meanwhile the preoperative ergometry evinced signs of ischemic ST-segment changes in almost all patients. Angiographically a patent anastomosis of the flap artery implanted into the aorta was found as well as a good contrast of the graft. Thus, "indirect myocardial revascularization" may be a surgical alternative treatment for patients suffering from therapy refractory ischemic heart disease.
Beyer
M
M
Universitätsklinik Ulm, Abt. Chirurgie IV - Herzchirurgie.
Mierdl
S
S
Scheunert
T
T
Schleich
S
S
Oertel
F
F
Hannekum
A
A
D000368:Aged; D018421:Cardiomyoplasty / Q000379:methods*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D004562:Electrocardiography; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery*; D009204:Myocardial Revascularization / Q000379:methods*; D018919:Neovascularization, Physiologic / Q000502:physiology*; D016896:Treatment Outcome