The History of Transmyocardial Revascularization

Abstract

In 1933, J.T. Wearn [1] reported the discovery of natural channels connecting the left ventricular chamber to the myocardial interspaces of the human heart. The transmyocardial channels were confirmed microscopically by gelatin filling of these tiny clusters of “arteries”. They connected distally to other channels woven into the fabric of the muscular fibers; these distal channels were termed myocardial sinusoids. Earlier, in 1708, Adam Christian Thebesius (1686–1732), a German physician, had described connections of the coronary veins with the myocardium, which were named thebesian veins in recognition of his discovery. In 1898 the American physiologist F.H. Pratt perfused oxygenated blood through the left ventricular wall in a cat and kept it live for more than an hour with this myocardial blood supply alone. In 1926, R.T. Grant reported that a congenitally deformed child had cardiac sinusoids connecting with the surrounding veins and arteries. In 1935, Claude Beck [2] reported in the Annals of Surgery his development of a new means of supplying blood to the myocardium. This external source of blood from the epicardial surface, which he called “myocardial neocapillary formation”, was produced by iatrogenic, traumatic scarring of the myocardium, combined with omentopexy and myopexy.