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We performed percutaneous transluminal coronary recanalization (PTCR) in 90 patients within 12 hours of onset of acute myocardial infarction (AMI). Fifty seven patients had total occlusion and 33 patients had subtotal occlusion of the involved coronary artery. Reopening of the occluded coronary artery by injection of isosorbide dinitrate (ISDN) was achieved in 24.4%. Continuous infusion of Urokinase was effective in 82.7%. Comparison of conventional therapy with PTCR showed that ejection fraction was higher in patients with PTCR than in those with conventional therapy, and that wall motion shortening was better in the former than in the latter. Relationship of regional wall motion shortening to the time interval from the onset of AMI showed that wall motion shortening was better it recanalized within 3 hours to and was fine within 6 hours, but poor after 6 hours of onset of AMI.

Effect of transluminal coronary recanalization on left ventricular regional wall motion and clinical course in acute myocardial infarction.