Emergent coronary artery bypass grafting for cardiogenic shock caused by very late drug-eluting stent thrombosis

We describe a case of cardiogenic shock caused by a very late drug-eluting stent (DES) thrombosis. The patient underwent emergent coronary artery bypass grafting (CABG) and was discharged home 15 days after the operation. The incidence of stent restenosis had been reduced by the use of DES, but the...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2009-11, Vol.57 (11), p.609-611
Main Authors: Boffini, Massimo, Ceresa, Fabrizio, Sansone, Fabrizio, Ribezzo, Marco, Comoglio, Chiara, Rinaldi, Mauro
Format: Article
Language:English
Subjects:
Angioplasty, Balloon, Coronary - adverse effects
Angioplasty, Balloon, Coronary - instrumentation
Cardiac Surgery
Cardiology
Case Report
Coronary Angiography
Coronary Artery Bypass
Coronary Artery Disease - therapy
Drug-Eluting Stents - adverse effects
Emergency Treatment
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Platelet Aggregation Inhibitors - therapeutic use
Shock, Cardiogenic - diagnostic imaging
Shock, Cardiogenic - etiology
Shock, Cardiogenic - surgery
Surgical Oncology
Thoracic Surgery
Thrombosis - diagnostic imaging
Thrombosis - etiology
Thrombosis - surgery
Time Factors
Treatment Outcome
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Summary:We describe a case of cardiogenic shock caused by a very late drug-eluting stent (DES) thrombosis. The patient underwent emergent coronary artery bypass grafting (CABG) and was discharged home 15 days after the operation. The incidence of stent restenosis had been reduced by the use of DES, but the Achilles’ heel of DES is represented by a higher rate of stent thrombosis. In our case, the DES thrombosis occurred 5 years after its implantation, underlining the importance of prolonged dual antiplatelet therapy. Even though rare, this complication may be life-threatening. We believe that CABG provides better event-free survival than percutaneous coronary intervention in patients with multivessel coronary disease despite the use of DES.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-009-0455-8