Coronary Artery Bypass Grafts: Success After Selective Intracoronary Thrombolysis in Acute Myocardial Infarction

• Thirteen of 19 patients undergoing streptokinase infusion within five hours after acute myocardial infarction were deemed satisfactory candidates for bypass surgery. In all cases, operation was performed within less than a week, with no demonstrable ill effects from the enzyme. There was only one pulmonary-related death and only two patients in whom the results have been less than satisfactory. Eleven patients have markedly benefited from the combination of procedures, demonstrating excellent functional myocardial preservation. Radioisotope myocardial scan, exercise ECG, and repeat cardiac catheterizations have been used to assess myocardial status. ( Arch Surg 1983;118:970-972)