Hello. Welcome to HCM and thank you for your question. I understand your concern. In cases of heart attack, and if a patient suffering it is admitted within, ideally 6 hours, but also 12 hours after onset of chest pain, then a coronary angiogram is performed, to evaluate where is the main blockage that is causing the myocardial infarction, and the first step is to try and treat that culprit artery with angioplasty (balloon dilation) and stent placement. This is to open the blocked artery, dissolve the clot blocking it and restoring the blood flow (oxygen and valuable nutrients) in the area distal from the occlusion. This is the first step that any university or secondary clinic tries to undertake. If the occlusion is in a delicate place, where stent placement is more risky than it brings benefits, then cardiac surgery could be tried also. It is highly risky to operate on a heart that is undergoing a heart attack, but this can be undertaken as a last resort and a rescue after failing of angioplasty + stent placement. Ideally, cardiac surgery in an infarction terrain, can be carried out two to four weeks after the acute myocardial infarction, because it is the period that heart needs to be stabilized. I hope I was helpful and informative. Take care and good luck. Regards, Dr. Meriton