Late coronary stent infection: a difficult to diagnose rare complication after percutaneous coronary intervention
| Autor: | Chintan Sheth, Amit Chandan, Dhaval Naik, Niren Bhavsar, Parloop Bhatt, Milan Chag, Hiren Dholakiya, Deepa Shah, Dhiren Shah |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Percutaneous business.industry medicine.medical_treatment Percutaneous coronary intervention Stent Case Report 030204 cardiovascular system & hematology Cardiac surgery Surgery 03 medical and health sciences 0302 clinical medicine surgical procedures operative 030228 respiratory system Cardiothoracic surgery Coronary stent Conventional PCI medicine cardiovascular diseases Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Indian J Thorac Cardiovasc Surg |
| Popis: | Percutaneous transluminal coronary angioplasty (PTCA) with drug-eluting stent placement is a well-established treatment modality for coronary stenotic lesions. Although infection involving implanted stent is rare, it can occur at any point of time, leading to high morbidity and mortality. We describe a rare case of infected coronary stents complicated with recurrent stent thrombosis, sepsis, and myocardial abscess formation after 2 years of percutaneous cornary intervention (PCI). Using multi-modality imaging final diagnoses to evaluate the precise location, extent and morphology of myocardial abscess (MA) was done. “On pump” coronary artery bypass graft (CABG) was performed, left anterior descending (LAD) artery intramyocardially was opened up, about 7–10 ml of pus was evacuated, and two drug-eluting stents (DES) were removed. The isolated identified organism was Pseudomonas aeruginosa which had remained dormant and restricted to the stent area for almost 2 years thinning the myocardium; an unusual trait of a very virulent bacterium which otherwise spreads fast to cause septicemia. The present case exemplifies the high index of clinical sensitivity with early multi-modality diagnosis, aggressive medical therapy, multidisciplinary care, and timely surgical intervention saving the patient’s life in otherwise fatal condition. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|