Eight patients have undergone myocardial revascularization procedures during the acute phase of myocardial infarction. Coronary anatomy had been determined preoperatively by coronary arteriography. Seven patients survived surgery, and six of the survivors have remained free of pain since surgery. This type of surgery is not recommended for all patients with acute myocardial infarction. However, those patients with infarctions complicated by shock, persistent pain, uncontrollable arrhythmias, or severe congestive heart failure should at least be considered for study and should possibly be considered for appropriate surgery.