Saphenous Vein Bypass Surgery for Impending Myocardial Infarction

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Abstract
Seventeen patients considered to have impending myocardial infarctions were subjected to saphenous vein bypass operation. Each patient had experienced recurrent angina pectoris with electrocardiographic changes of transient ischemia, but no infarction and no enzyme abnormalities. Paroxysmal ventricular tachycardia had occurred in seven patients, and ventricular fibrillation and cardiac arrest in two more. Two patients received triple grafts, 12 received double grafts, and three received only one graft. Three died and three experienced acute myocardial infarctions during operation. Follow-up study revealed that angina pectoris was absent in all patients except one; 11 patients returned to full-time employment, and no arrhythmias recurred. Patency of graft was noted in 85%, or 28 of 35 grafts. The operation may be advised for patients with impending myocardial infarction, as well as for those with life-threatening arrhythmias unresponsive to antiarrhythmic agents.