PERICORONARY NEURECTOMY IN ABOLISHING ANGINAL PAIN IN CORONARY DISEASE

Abstract

A SURGICAL procedure to be of optimum value in the treatment of coronary disease must simultaneously improve the coronary circulation, block vasomotor reactions and eradicate anginal pains.¹ Operations now in use cannot achieve full benefit for the patient with coronary disease, as their specific objective is limited either to the interruption of nerve pathways that may carry pain impulses or to the improvement of the coronary circulation. Cervical or dorsal sympathectomy may interrupt some impulses originating from the coronary vessels or the myocardium; yet it is not satisfactorily demonstrated experimentally that all important pathways carrying impulses to and from the coronary arteries are cut or that an improvement in coronary circulation follows. Cutler² stated, "My own experience in this field comprises a considerable number of surgical attacks on the sympathetic apparatus in the neck and on the upper two dorsal ganglia. I have never been convinced that the