[Patient who developed acute myocardial infarction after total-gastrectomy].
We report a case of a man who underwent coronary artery stent placement, and developed acute myocardial infarction immediately after total-gastrectomy. Thirty-seven days before surgery, he developed an AMI due to 90% stenosis of #1 of the right coronary artery, for which a bare-metal stent was inserted. After the procedure, the patient took aspirin and ticlopidine, which were discontinued preoperatively. Even though the surgery progressed uneventfully, the patient developed ST-T segment elevation in II, III, aVF and complete A-V block soon after surgery. Emergency coronary angiography demonstrated 100% stenosis and clotting of the stent part, for which emergency thrombectomy was required. In conclusion, the risk is very high in the operation early after the insertion of BMS. Therefore, it is better to wait as long as possible and to avoid the easy stopping of the anticoagulant-drugs. It may be also better to give epidural-anesthesia.
Sekiya
Yoshiaki
Y
Department of Anesthesiology, University of Tsukuba Hospital, Tsukuba 305-8576.
Takahashi
Hiroshi
H
Tanaka
Makoto
M
D000368:Aged; D000767:Anesthesia, Epidural; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy; D003328:Coronary Thrombosis / Q000150:complications; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008670:Metals / Q000009:adverse effects; D009203:Myocardial Infarction / Q000209:etiology* / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D015607:Stents / Q000009:adverse effects; D013274:Stomach Neoplasms / Q000601:surgery
D008670:Metals; D010975:Platelet Aggregation Inhibitors