[Retrograde myocardial revascularization using a bypass into the cardiac vein]

The authors submit a review of the surgical treatment of ischaemic heart disease, and based on data from the literature and their own experience, they evaluate the asset of so-called indirect revascularization operations under conditions when an aortocoronary bypass is impossible or has only a short-term effect due to the diffuse sclerotic affection of the coronary circulation. Special attention is paid to attempts of retrograde revascularization of the heart muscle by bypasses into the coronary veins. Because at present the possibility of indirect revascularization of the myocardium by a retrograde approach via the cardiac veins still remains a by far not yet resolved problem, the authors recommend for situations where the aortocoronary bypass is out of question a procedure making use of the advantages of a direct aortocoronary bypass and Vineberg's operation performed so as to relieve the blood flow through the sclerotic coronary artery beneath the anastomosis. In special situations also a sequential bypass could be considered with a side-to-side anastomosis into the artery and end-to-side into the appropriate vein.