Coronary Stent Thrombosis during Noncardiac Surgery: A case report. |
Hyun Hea Kim, Jai Hyun Hwang |
Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. jhhwang@amc.seoul.kr |
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Abstract |
We report a 62-year-old man who expired due to intraoperative stent thrombosis. He presented for radical cystectomy because of a bladder cancer. Before a surgery, coronary stent intervention was performed at left anterior descending (LAD) artery. And then he received dual antiplatelet medication for three weeks. Four weeks later, he had an operation for bladder cancer. During the surgery, arrhythmias were developed. After the surgery, the patient suffered from a ST segment elevation myocardial infarction, which was caused by total occlusion of the stent. Additional stent implantation was performed but immediately after the procedure, uncontrolled ventricular arrhythmias developed.
It seems that patients with stents may be at heightened risk of stent occlusion during and after surgery. They should be required safe waiting period, titrated anticoagulatory therapy and exact monitoring of myocardial ischemia during the entire perioperative period. |
Key Words:
noncardiac surgery; percutaneous coronary intervention; stent thrombosis |
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