Abstract: Computer controlled apparatus and method for enhancing myocardial revascularization using direct vessel implants includes a probe for insertion into a proposed graft site to determine the condition of the site using criteria such as oxygen levels, contractility and pressure/flow rate differentials in conjunction with the parameters of the selected vessel graft. Transmyocardial revascularization procedures are performed to increase flow rates when needed and to supplement graft treatment where desired. A coring device creates the opening for the graft and correlates the size of the opening with contractility conditions and vessel conditions. Reinforcement sleeves may be placed around grafts, particularly vein grafts, to avoid excess compression of the graft. Graft site preparation and TMR treatment enhance angiogenesis and collateralization of the implant, and angiogenic drugs may be used to increase such effects.