SummaryThe author recalls the history of Fieschi operation and the experimental work done about it. He reports his own experience in using that technic and the results obtained with regard to the clinical condition of the patients and their E.C.G. tracing. When this operation seems insufficient, the author performs an epipericardio-epicardiopexy, which removes the avascular membrane of the pericardium and facilitates the appearance of anastomoses and the development of collateral coronary circulation.