Emergency CABG for closing stent in Coronary Artery
- drpavankumar
- 0
- on Mar 31, 2020
Emergency CABG for closing stent in Coronary Artery.
Mr. M. K. 69-year-old man was diagnosed to be having Diabetes, Hypertension since the last 5 years he suffered effort angina in early 2018 for which he underwent coronary angiography, which showed an 80% block in LAD vessels & 40% in circumflex & 30% block in RCA. He underwent PTCA / 2 stent implantation to LAD in July 2018 to relive in anginal symptoms. He remained alright till March 2020. When he again developed angina. A repeat angiography showed that he had in-stent stenosis/blockage in the stent of 99% with very sluggish blood flow across the stent. Due to his continuous chest pain. He was taken up of emergency CABG by Dr. Pavan Kumar Consultant Cardiac Surgeon at Lilavati Hospital, Mumbai, India. He underwent Triple Vessel CABG successfully for this emergency closing down in-stent stenosis & other vessels Circumflex & RCA blocks which progressed to become 70% & above respectively. The patient recovered completely & discharged on 7th Postoperative day.
Discussion :- Coronary Angioplasty by DES ( Drug-Eluting Stent ) stents has 5% – 10% / year stent block rate. Restenosis or stent occlusion incidence increases significantly. If the patient has Diabetes, Hypertension & hypercholesterolemia. This patient also had Insulin-dependent diabetes & hypertension & despite been on dual antiplatelet therapy his stent got blocked one and half years of Angioplasty. It was lucky that this was diagnosed in time without him getting heart attack & permanent damage to his heart. Early CABG is crucial in these settings & for successful results.