Direct-Vision Coronary Endarterectomy for Angina Pectoris

Abstract

OF the numerous surgical procedures1 2 3 4 5 6 7 so far designed to increase blood flow to the myocardium in patients with angina pectoris, none have won wide acceptance since conclusive evidence of their therapeutic benefit has been lacking. It seemed to us that the most effective means of increasing myocardial blood flow would be to remove the obstructing atheromatous plugs from the coronary arteries themselves. Experience with peripheral arterial endarterectomy suggested the possibility of a direct surgical approach by this method to occluded coronary arteries. The feasibility of such an operation was supported by both pathologic and experimental observations of one of us . . .