Direct selective myocardial revascularization by internal mammary artery-coronary vein anastomosis.

In this report, we shall describe our work with retrograde coronary perfusion, first in mongrel dogs and then in 6 patients. The left internal mammary artery (LIMA) is anastomosed to the left anterior descending coronary vein (LADV) to provide myocardial perfusion. This procedure may be of great value in the treatment of patients who are not suitable candidates for direct coronary bypass grafting, i.e., those who have diffuse atherosclerosis, with poor or no runoff of the left anterior descending coronary artery (LADA),but who have satisfactory left ventricular contraction.