Surgical treatment of acute evolving anterior myocardial infarction

A series of 101 consecutive patients underwent coronary revascularization within a mean of 5.8 hours after anterior myocardial infarction. Forty-one patients had obstruction of the left anterior descending coronary artery (LAD), 35 had obstruction of the LAD and of the right or circumflex coronary artery and 25 had obstruction of the LAD and both the right and circumflex coronary arteries. Sixty-four patients (63%) had total occlusion of the LAD. In-hospital mortality was 2%. The total mortality during a mean follow-up of 43 months was 5%, and 90% of the patients were free of angina. Thirty-six patients had repeat coronary arteriography a mean of 13.4 months after operation. Fifty-two of 62 grafts (84%) were patent. Cardiac catheterization and immediate coronary artery bypass grafting in the first hours of anterior myocardial infarction can be done safely and may reduce in-hospital and long-term mortality.