Acute coronary syndrome and myocardial infarction after orthopedic surgery in a patient with a recently placed drug-eluting stent

J Clin Anesth. 2006 Nov;18(7):537-40. doi: 10.1016/j.jclinane.2006.03.011.

Abstract

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip* / mortality
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / surgery
  • Hip Dislocation / complications
  • Hip Dislocation / mortality
  • Hip Dislocation / surgery
  • Humans
  • Male
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / mortality
  • Postoperative Complications* / metabolism
  • Stents*
  • Syndrome