Hospital deaths from acute myocardial infarction are the consequence of cardiac arrhythmias and cardiac pump failure. However, for a limited period of time following the interruption of the coronary blood flow, a significant portion of the myocardium remains in a situation of "reversibility", which means that if the coronary flow is reestablished, the infarcted area is reduced. Pos-acute myocardial infarction reperfusion methods include thrombolytic therapy, percutaneous transluminal coronary angioplasty and surgical revascularization of the myocardium. The indications for the latter method, which is employed when procedures such as thrombolysis and percutaneous transluminal coronary angioplasty have failed, are analyzed and the results are discussed in terms of the time elapsed since the onset of acute myocardial infarction, ejection fraction, the number of vessels involved, the type of infarction and the concurrence of cardiogenic shock. The advisability of adopting different strategies and priorities for surgical revascularization in certain situations is indicated.