FIRST CLINICAL-RESULTS WITH INDIRECT MYOC ARDIAL REVASCULARIZATION - FREE SKELETAL-MUSCLE FLAP FOR INDUCTION OF EPI-MYOCARDIAL NEOVASCULARIZATION

Patients with multiple and peripherical coronary stenosis are not suit able for direct coronary artery surgery. For these patients a new surg ical myocardial revascularization was developed. This new surgery was adopted on 5 patients from May 1993 through May 1995. The operation co nsisted in the grafting of a free skeletal muscle flap onto the anteri or 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 fr om angina. The postoperative bicycle ergometry showed no signs of isch emic ST-segment changes, meanwhile the preoperative ergometry evinced signs of ischemic ST-segment changes in almost all patients. Angiograp hically a patent anastomosis of the flap artery implanted into the aor ta was found as well as a good contrast of the graft. Thus, ''indirect myocardial revascularization'' may be a surgical alternative treatmen t for patients suffering from therapy refractory ischemic heart diseas e.