| A Case of Emergency Off-Pump Coronary Artery Bypass Grafting after DES Stenting |
(Department of Cardiovascular Surgery, Fukuoka University, School of Medicine, Fukuoka, Japan)
| Hidehiko Iwahashi |
Tadashi Tashiro |
Noritsugu Morishige |
| Yoshio Hayashida |
Kazuma Takeuchi |
Nobuhisa Ito |
| Koji Akasu |
Go Kuwahara |
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A 75-year-old man was admitted with symptoms of unstable angina pectoris. The patient was initially treated with ticlopidine and aspirin after first undergoing percutaneous coronary intervention (PCI) by means of a drug eluting stent (DES). Coronary angiography thereafter showed re-stenosis in left main trunk and two-vessel disease. As a result, emergency off-pump coronary artery bypass grafting (OPCAB) was therefore performed. However, major bleeding (3,245ml) occurred after OPCAB. Therefore, a re-thoracotomy operation had to be performed to stop the bleeding. Based on the above findings it is important for surgeons to keep in mind that pre-operative ticlopidine administration can increase the risk of re-operation for hemostasis, while also potentially increasing and the requirements for blood and blood product transfusion both during and after OPCAB surgery.
Jpn. J. Cardiovasc. Surg. 36: 166-169 (2007) |
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