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The patient is a 63-year-old, obese man with diabetes, hy-pertension, dyslipemia, and a positive familial history of coronaryartery disease and previous myocardial infarction in the inferiorwall 4 years earlier. Twelve days previously, the patient had anacute myocardial infarction in the anterior wall, which evolvedfor 14 hours. The patient underwent angioplasty and successfulstent implantation but began to complain of fatigue on mild effortand nocturnal paroxysmal dyspnea.The electrocardiogram showed third-degree left bundle-branchblock. The echocardiogram showed cavitary enlargement, anteriorand inferior akinesia, and an ejection fraction of 24%. Thallium-201 myocardial scintigraphy showed anterior and inferior fibrosis.The cardiac catheterization evidenced a significantly enlarged ven-tricle due to anterior and inferior akinesis, and apical dyskinesis.On angiography, the ejection fraction was 25%, and the left ven-tricular Pd2 was 34 mmHg. The right coronary artery showed adiffuse lesion in its proximal segment and distal occlusion. Theleft main coronary artery had no obstruction, the circumflex arteryhad parietal irregularities and occluded marginal branches, andwas opacified through the homocollaterals. The anterior descen-ding artery was diffusely damaged from the junction of the middleand distal segments onwards. The first medium-caliber diagonalbranch had a severe lesion in its origin.Taking all this into consideration, the patient and his familywere presented with the possibility of retrograde bone-marrowstem cell injection through the anterior descending vein to causemyogenesis and angiogenesis. The patient agreed with the pro-cedure proposed, as did the committee on ethics subordinate tothe Argentinean government and Health Ministry.With the patient under general anesthesia, puncture of theiliac crest and bone marrow aspiration were performed.The upper layer (leukocyte concentrate containing mononuclearcells) was separated from the erythrocytes by centrifugation, andthe latter were reinfused into the patient. Then the leukocytic

Terapia de células-tronco no infarto agudo do miocárdio, através de perfusão coronariana retrógrada: uma nova técnica