[Cardiomyopexy--current status of an indirect revascularization method].

From May 1993 to September 1995, six patients underwent a new myocardial revascularization procedure. These patients were not suitable for direct coronary artery surgery due to diffuse and peripheral coronary stenosis and severe angina pectoris (NYHA classes III-IV). Thus, indirect myocardial revascularization or cardiomyopexy was performed. This consists in the grafting of a free skeletal muscle flap onto the ischemic heart. After harvesting the musculus latissimus dorsi as a free flap, the graft was transplanted onto the heart. The arterial stump of the muscle flap artery was implanted directly into the aorta, venous flow was drained into the right atrium. There to four weeks after the intervention the patients were free from angina. Ischemic ST-segment changes appearing preoperatively at 50 W disappeared 8 weeks later even at a higher exercise tolerance. The two patients that underwent the intervention in 1993 and 1994 are still free from angina. In the present work experimental and clinical experiences with indirect myocardial revascularization are summarized and discussed.