[Indications for a multiple aortocoronary bypass].

Coronarograms recorded from 101 patients with ischemic heart disease are appraised. Four hundred coronary arteries were examined, a marked stenosing process was found in 259, i. e. 2.5 affected arteries on the average per each heart. In diffuse coronary sclerosis, the most complete myocardial revascularization is only possible when the blood flow is restored in several coronary arteries. A shunt should be created on no more than 4 arteries. The anterior interventricular and right coronary arteries and the diagonal and lateral branches of the left coronary artery are used most frequently for establishing aorticocoronary shunts. The volume of the operation in multiple shunting is determined by the number of affected arteries and their anatomical distribution and physiological importance in the myocardial blood supply. It is necessary to create 2.3 shunts on the average.