AbstractOperations that reestablish flow to proximally obstructed coronary arteries are being applied with greater frequency and greater success. The long‐term effects of such operations will ultimately be measured by increased longevity for patients with coronary artery disease, providing that perioperative injury is held to an absolute minimum and technical expertise is maintained at an absolute maximum. Application of myocardial protective techniques requires a knowledge of coronary and myocardial physiology. The use of nonrandomized applications of new protective techniques is strongly discouraged since such adventures provide little insight for the future. Further elucidation of the safe intervals for brief periods of ischemia in hearts with and without obstructed coronary arteries is needed, as are more refined measurements of physiologic and biochemical effects of revascularization techniques in regions of myocardium supplied by heterogeneously affected coronary arteries.