Since 1990 forty-one cardiomyoplasty procedures (CMP) were performed in 35 patients with ischemic and in 6 patients with dilated cardiomyopathy. All surviving patients (n=33) revealed decreased functional NYHA class from III to I-II, increased ejection fraction (EF) by a mean of 10 por cento. Results of roentgencontrast ventriculocoronarography (n-8), of radioisotope (n=28) and morphologic (n=9) studies demonstrated the presence of indirect revascularization (IR) of myocardium from the arteries of e transplanted latissimus dorsi muscle (LDM). Thus effective CMP in patients with severe heart failure is firstly a result of myocardial IR development and secondly of LDM functioning as a biomechanical assist device.