Experimental myocardial neovascularisation with a free muscle flap in the dog

Patients with diffuse small vessel coronary artery disease are often not suitable for direct coronary artery surgery. To gain insight into this problem, the effects on myocardial revascularisation of a free skeletal muscle flap anastomosed to the internal mammary artery were studied in 6 dogs. Four weeks after production of a zone of multiple microinfarctions of the anterior wall of the heart, a free flap of pectoralis muscle was grafted onto the heart. Sixteen to 18 weeks later the animals were sacrificed, and their hearts were subjected to histological and a microvascular corrosion cast examination. The results showed extensive development of a prominent vascular network penetrating from the graft into the heart. Thus, myocardial revascularisation in the dog is possible by grafting a free skeletal muscle onto the heart.