[Intracoronary lysis of acute myocardial infarct].

A report is presented on 21 patients admitted with acute myocardial infarction in whose pain duration had not exceeded three hours. The coronary angiogram revealed occlusion of the supply-vessel to the infarcted area in 18 patients and only subtotal stenosis in the 3 remaining cases. Intracoronary administration of streptokinase (2000 to 4000 U/min) achieved thrombolysis in 15 out of 18 patients (83%) with thrombotic occlusion. All patients with exception of 2 patients revealed after thrombolysis a greater than or equal to 80% remaining stenosis. 2 patients without successful recanalisation died due to pump failure on the first or fourth day, respectively, following myocardial infarction. Reinfarction occurred in 2 patients out of successful treated cases, 4 patients required aortocoronary bypass-surgery for impending reinfarction or unstable angina pectoris. Angiographic control in the fourth week following myocardial infarction demonstrated reocclusion of the corresponding vessel in 3 cases, 2 of whose had a reinfarction. There was no change in the mean ejection fraction in the patients with persistent recanalisation between the acute and the chronic stage of infarction.