[Non cardiac surgery in patient with coronary stenting: think sirolimus now!].
We describe a severe preoperative cardiogenic shock in a patient scheduled for a breast surgery. The cardiogenic shock was in relation with thrombosis of two sirolimus-eluting stents received 3 months ago. A percutaneous transluminal coronary angioplasty was successfully performed. The patient recovered well after a 1-day treatment including intraaortic balloon counter pulsation and dobutamine infusion. We discuss about the ideal timing to plan surgery and how to manage the shift of antiplatelet agents.
Fléron
M H
MH
Département d'anesthésie-réanimation, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France. mh.fleron@psl.ap-hop-paris.fr
Dupuis
M
M
Mottet
P
P
Le Feuvre
C
C
Godet
G
G
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001940:Breast / Q000601:surgery; D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004280:Dobutamine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D012770:Shock, Cardiogenic / Q000209:etiology; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects*; D015607:Stents; D013927:Thrombosis / Q000209:etiology
D002316:Cardiotonic Agents; D007166:Immunosuppressive Agents; D004280:Dobutamine; D020123:Sirolimus