Revascularization of the Dog Myocardium

Many attempts have been made to develop a surgical procedure which would effectively revascularize the ischemic human heart. These operations are evaluated in the laboratory, usually on dogs, before applying them to humans. Since the first experimental myocardial revascularization procedure on dogs in 1932,²⁰six basic methods of approaching this problem have evolved. 1. Inflammatory agents have been applied to the surface of the heart to create adhesions between the visceral and parietal pericardium.³⁻⁵,⁷,²⁶,²⁷Extracardiac vessels can traverse these adhesions and thus provide a new source of blood supply to the myocardium. 2. Pedicled grafts of skin, muscle, pericardial fat, lung, and omentum have been sutured to the myocardium.¹³,¹⁹,²²The vessels sustaining the graft then act as an extracardiac source of arterial blood for the myocardium. 3. Retrograde arterial perfusion of the myocardial capillary bed by connecting the coronary sinus to the aorta by direct anastomosis or