Historical review of development of indirect methods of myocardial revascularization

The article presents a historical review. For several decades, the diseases of the circulatory system have remained one of the most pressing problems of mankind. However, in the recent years there has been a tendency to decrease in mortality from cardiovascular pathologies including coronary heart disease. At the dawn of the study of coronary artery disease, the problem of surgical treatment of coronary artery pathology looked practically unsolvable: there was no knowledge of pathophysiology, no microsurgical instruments, and artificial circulation apparatus. Among other things, the stereotype of the "inviolability" of the heart muscle firmly entrenched in the minds of operating surgeons. A safe operation on a human heart was only a dream and the object of ridicule among most surgeons of the XIX – early XX centuries. The article describes the history of the study of angina pectoris and indirect methods of myocardial revascularization. The first operations were aimed at eliminating pain syndrome and inducing angiogenesis, creating neocollaterals from blood vessel-rich organs and tissues to improve regional myocardial perfusion. Exactly these surgical techniques have become a "bridge" from the tactics of exclusively conservative management of heart pathologies to modern cardiac surgery.