From January 1972 through August 1973, direct myocardial revascularization by saphenous vein bypass grafting was performed in 108 patients using ischemic cardiac arrest. One patient died in the hospital. There were no deaths in patients undergoing circumflex grafts. In order to minimize ischemic time, the operative technique included alternating distal and proximal anastomoses, using total aortic occlusion for the distal anastomosis, partial aortic occlusion for the proximal anastomosis, and a running suture method. Follow-up results indicate marked improvement in symptomatic relief; only one patient was not improved. This technique has proved more satisfactory than that of electrical fibrillation used in a previous series where six patients of 58 were hospital deaths.