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S.V.

JAMA. 1970;213(4):616-617.

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By its very definition refractory to standard medical treatment, intractable angina has for long been exposed to unorthodox surgical and medical therapies which provoke disagreement. Cervical ganglionectomy for interrupting afferent impulses, thyroidectomy or radioactive iodine thyroid ablation for reducing metabolic demands on the myocardium, and various procedures such as epicardiectomy or omental grafts for inducing collateral circulation have provided material for many lively disputes. These procedures are now all but abandoned. Myocardial revascularization, however, is currently undergoing a remarkable resurgence after a long decline which followed the interest generated by Vineberg's internal mammary artery implantation. And although the original Vineberg operation¹ is no longer in common use, it has served over the past decade as a prototype for more widely employed modifications and offshoots made possible by advances in radiographic and surgical technology. Diagnostic coronary cinearteriography and operative cardiopulmonary bypass now enable the surgeon to localize accurately the site . . . [Full Text PDF of this Article]

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