RESUMO
The utilization of thrombolytic agents during the first hours of acute myocardial infarct has been accepted as one of the main methods to limit infarct extension. However, persistence of residual stenosis requires a complementary revascularization method. Twenty-five patients with a diagnosis of acute myocardial infarct were successfully treated within six hours from onset of symptioms with intravenous streptokinase, followed 1 to 21 days (mean of 8 days) afterwards by surgical revascularization of the myocardium without extracorporeal circulation. The mean age of the group was 53.8 years and the mean ejection fraction 60 per cent; 10 patients were uniarterial, 14 biarterial and 1 triarterial; in 15 patients the infarct was located at the anterior wall and in 10 at the posterior wall. Eight patients received one bypass and 17, two. Our nosocomial mortality was 0 per cent and in none was there a need for reoperation due to bleeding. Surgical revascularization of the myocardium withou using extracorporeal circulation is thus a method that can be used in some patients with acute myocardial infarct with excellent results regarding morbidity and nosocomial mortality