Myocardial revascularization using Omentum graft "Old wine in a new bottle"

Background. Therapeutic angiogenesis in cardiovascular disease aims at improving myocardial function by increasing blood flow to ischemic myocardium that is not amenable to traditional forms of revascularization. This study hypothesizes that using the Omental graft to wrap the ischemic heart will lead to formation of multiple collateral anastomoses between surrounding systemic arteries and the coronary arteriolar system of right and left coronary arteries.Results. Left ventricular end diastolic pressure was reduced in the group treated with revascularized Omental graft compared to vehicle group. Ejection fraction was also improved in revascularized group then infarcted group. Measurements of the myocardial infarction area showed more reduction in the MI area of the revascularized group than in the vehicle group, however this difference did not reach statistical significances. In comparison between free and pedicle Omental grafts, the free Omentum was shown to be superior over the pedicle in terms of cardiac function EF% (41.3 +/- 0.75 Vs. 35.6 +/- 0.75, P = 0.01), and infarction size (36.2 +/- 6.6 Vs. 39.5 +/- 13, P = NS). All different Omental grafts showed the ability to form a neovascularization between the ischemic myocardium and the surrounding structures