[Coronary arteriography in recent myocardial infarct].

Sixty patients with a recent transmural acute myocardial infarction had seletive coronary arteriography carried out between the 7th and the 29th day (mean 17 +/- 2 days) after the onset of the condition. The anterior infarction (n = 25 cases) had a total obliteration in 36% of cases, and most often (64%) a stenosis of the anterior descending artery with an excellent distal bed (80%). The collateral circulation is often zero (76% of cases); 80% have adjacent lesions on the right coronary or circumflex artery, but 7 patients out of 25 would have been able to have a preventive bypass operation. The posterior infae lesions are often sited electively at the level of the artery of the S/A node or in the middle of the second vertical segment in the region of the right ventricular branch. Thus the infarct is the result of a complex lesion of the right coronary and circumflex arteries, because the latter is affected in three cases out of four. 63% of patients with a postero-inferior infarction have diffuse lesions, and 13 out of 35 could have had a preventive bypass procedure. This study shows: 1. That this investigation is well-tolerated after a recent infarction; 2. The high incidence (43%) of stenoses at the edge of the area of necrosed myocardium; 3. The importance of this investigation in finding the nearby lesions which are very frequently associated: in 33% of cases, preventive bypass would have possible.