One hundred and thirty-nine patients with acute myocardial infarction (MI) were followed up for 4 to 48 months after intracoronary thrombolysis. Postinfarction cardiovascular function was better in patients subjected to aortocoronary shunting or transcutaneous transluminal coronary angioplasty after antegrade blood flow recovery by thrombolysis. They had a significantly lower incidence of anginal pains, better working capacity and smaller MI recurrence rates. Effective intracoronary thrombolysis alone, unassisted by the elimination of residual stenosis, failed to produce basic improvement in subjective as well as objective postinfarction condition of the patients who remained at high risk for repeated MI due to a coronary re-occlusion.