Acute coronary syndrome and myocardial infarction after orthopedic surgery in a patient with a recently placed drug-eluting stent.
Providing anesthesia care for patients who have recently undergone intracoronary drug-eluting stent placement presents unique clinical challenges. It is currently recommended that these patients remain on antiplatelet therapy until reendothelialization of the vessel has occurred (ie, 3-6 months, depending on the eluting medication) to prevent stent restenosis. In the setting of urgent or emergent surgery, it may not be possible to wait until a full course of antiplatelet therapy has been completed. We report an unusual case of postoperative acute coronary syndrome in a gentleman who underwent intracoronary stenting 7 weeks before nonelective revision hip arthroplasty. To our knowledge, this is the first case in the anesthesia literature to report postoperative cardiac morbidity after recent drug-eluting stent deployment.
Brown
Michael J
MJ
Department of Anesthesiology, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Long
Timothy R
TR
Brown
Daniel R
DR
Wass
C Thomas
CT
D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000601:surgery; D006617:Hip Dislocation / Q000150:complications / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D011183:Postoperative Complications / Q000378:metabolism; D015607:Stents; D013577:Syndrome