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

Gen Thorac Cardiovasc Surg. 2009 Nov;57(11):609-11. doi: 10.1007/s11748-009-0455-8. Epub 2009 Nov 12.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / instrumentation
  • Coronary Angiography
  • Coronary Artery Bypass*
  • Coronary Artery Disease / therapy*
  • Drug-Eluting Stents / adverse effects*
  • Emergency Treatment
  • Humans
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Shock, Cardiogenic / diagnostic imaging
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / surgery*
  • Thrombosis / diagnostic imaging
  • Thrombosis / etiology
  • Thrombosis / surgery*
  • Time Factors
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors