384 patients with ischaemic heart disease were treated surgically. Out of 165 patients operated upon consecutively, in 38 (23%) an intramural course of coronary arteries was found. Peroperative diagnosis of the intramural course of the anterior interventricular branch is feasible with a high probability; diagnostic criteria were also elaborated for the intramural course of the marginal branch. Several aspects of the operation technique and tactics are discussed.
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