Triple and double arterial implantation for myocardial revascularization.

A technic was developed using a median sternotomy approach, by which triple or double arterial implantation in the myocardium might he carried out, using the right and left internal mammary arteries and the gastroepiploic artery. Triple or double arterial implantations were performed in 32 patients, two of whom died in the ;ostoperative period. Over 90 per cent of the remaining patients have been improved. Arteriographic studies six to 12 months after operation have demonstrated patency of all three vessels following triple implantation. Operation of this type is thought to be particularly suitable for patients with multiple areas of myocardial ischemia. In addition, the surgical approach permits a second operation for patients who have previously undergone implantation of the left internal mammary artery. In two patients, the right internal mammary artery and gastroepiploic artery were implanted at a second operation.