@article{oai:nagoya.repo.nii.ac.jp:00016631, author = {ISHIHARA, TOMOYOSHI}, issue = {3}, journal = {Nagoya Journal of Medical Science}, month = {Feb}, note = {Internal mammary artery implantation proposed by Vineberg is now in common use, and its effect on ischemic heart disease has been proved experimentally and clinically by many investigators. Some problems concerning the procedure, however, have not yet been clarified thoroughly. In order to elucidate these problems, the Vineberg procedure was experimentally evaluated and compared with three different methods to provide a new blood supply to the ischemic myocardium from a systemic artery. The structure of vessels pertaining to myocardial revascularization was investigated by means of microangiography, histology and plastic casting method. Results were analyzed and concluded, as follows: (1) Though the Vineberg procedure showed a high patency rate, it had some restrictions in length or flow rate of the implant. The myocardial sinusoid described by Vineberg to pertain collateral anastomoses failed to be identified. (2) Blood supply to the ischemic myocardium from the epicardial side using pericardia! patch showed poor result due to technical difficulties and frequent thrombotic obstructions. (3) No patency was obtained in the silicon rubber tube grafting method. Improvement in material and shape of the prosthesis should make the clinical application safe and easy. (4) The patency rate in the autogenous vein grafting method was excellent. Any portion of the myocardium was enabled to be covered with this method by preparing a required length of graft. Development of implanted vein-coronary artery anastomosis in this group was as good as in internal mammary artery implantation.}, pages = {257--286}, title = {The Experimental Studies on Surgical Treatment of Ischemic Heart Disease}, volume = {33}, year = {1971} }