title: Management of patients with coronary stents in elective thoracic surgery.
abstract: OBJECTIVE
  Interruption of oral antiplatelet agents for noncardiac surgery places patients who have received coronary stent implantation at high risk of coronary events, including stent thrombosis. We investigated retrospectively perioperative management for patients with coronary stents undergoing thoracic surgery.
  
  
  METHODS
  We investigated 38 patients (age, 38-83 years; 33 men and 5 women) who underwent thoracic surgery (35 lung cancer resections and 3 other procedures) after coronary stent implantation at our hospital between January 2006 and August 2010. Data on implanted stents, perioperative medications, and cardiac and hemorrhagic complications were analyzed.
  
  
  RESULTS
  Sirolimus-eluting stents (n = 18) and bare-metal stents (n = 20) were implanted. Regarding oral antiplatelet agents, 21 patients received aspirin, 16 received thienopyridine derivative and aspirin, and 1 received no oral antiplatelet agents. Oral antiplatelet agents were stopped 3-7 days before surgery. Perioperative heparinization was performed in 16 patients. Oral antiplatelet agents were restarted after confirmation of hemostasis and the lack of need for further invasive procedures (median, 4 days after surgery). No major cardiac events including stent thrombosis developed. There were no excessive intraoperative bleeding events related to oral antiplatelet agents or heparin.
  
  
  CONCLUSIONS
  In our patients, no coronary events occurred with the short-term stopping of oral antiplatelet agents for thoracic surgery.
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin-Kawara-cho, Sakyo-ku, Kyoto, 606-8507 Kyoto, Japan. mysonobe@kuhp.kyoto-u.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Sonobe
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sato
authors.forename: Fengshi
authors.initials: F
authors.lastname: Chen
authors.forename: Takuji
authors.initials: T
authors.lastname: Fujinaga
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shoji
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sakai
authors.forename: Ryo
authors.initials: R
authors.lastname: Miyahara
authors.forename: Toru
authors.initials: T
authors.lastname: Bando
authors.forename: Chen-Long
authors.initials: CL
authors.lastname: Huang
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D005260:Female; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D019616:Thoracic Surgical Procedures / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin