Myocardial replacement therapy.

Case Presentation: A 56-yearold farmer who experienced a transmural anterior myocardial infarction (MI) 3 years ago was referred for evaluation of progressive dyspnea and fatigue. During the acute phase of MI, he was treated with fibrinolysis, as primary angioplasty was not available at his local hospital. Angiography performed 3 months after MI revealed occlusion of the left anterior descending artery with diffuse changes distal to the occluded segment. An attempt at percutaneous recanalization had failed. Despite treatment with -blockers and angiotensinconverting enzyme inhibitors, serial echocardiograms performed by his local cardiologist had shown a large dyskinetic area and subsequently progressive dilatation and remodeling of the left ventricle. The patient is currently presenting with New York Heart Association class III symptoms and a history of several recent episodes of pulmonary edema.