Recanalization by transluminal coronary angioplasty (TCA) was attempted as the first measure in 41 patients having symptoms for less than 4h. The obstruction could rapidly be removed (between 14 and 50 min) in 38 patients (92%). Five patients (12%) died: one in shock at the end of the operation, two died on the 5th and 8th postoperative day and two from heart failure on the 8th and 15th postoperative day. Three patients were urgently operated on for severe tritruncal lesions after a successful TCA. Among the 27 patients under control between 1 and 12 months, six reocclusions were noted (5 asymptomatic, 1 with clinical recurrence), 5 had recurrent stenosis (3 of them were treated by a 2nd angioplasty) and 16 (60%) exhibited permanent good results. The global ejection fraction was not modified, neither the telediastolic and telesystolic volumes. A significant improvement in segmental kinetics was observed in 6 patients with anterior and in 5 patients with inferior infarction. In this group of patients the ejection fraction was improved (67.2 +/- 2.3 vs 52.8 +/- 2.2, p less than 0.001), the IVDT was unchanged (81.7 +/- 6.8 vs 90.7 +/- 5.1, NS). IVTS was lower (27.5 +/- 3.5 vs 41.9 +/- 2.8, p less than 0.001). Further work is, however, needed to confirm these results.