Ann Cardiovasc Surg | Volume 1, Issue 3 | Case Report | Open Access

A Late Coronary Stent Infection: Its Diagnosis and Surgical Treatment-A Case Report

Dhiren Shah^1*, Milan Chag², Deepa Shah³, Dhaval Naik¹, Amit Chandan¹, Chintan Sheth¹, Niren Bhavsar¹, Hiren Dholakiya¹ and Parloop Bhatt⁴

¹Department of Cardiac Surgery, CIMS Hospital, India
²Department of Cardiology, CIMS Hospital, India
³Department of Radiology, CIMS Hospital, India
⁴Department of Pharmacology, L. M. College of Pharmacy, India

^*Correspondance to: Dhiren Shah 

Abstract

Percutaneous Coronary Intervention (PCI) 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 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 ml to10 ml of pus was evacuated and 2 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.

Keywords:

Stent infection; Myocardial abscess; Cardiac magnetic resonance imaging; Positron emission tomography

Citation:

Shah D, Chag M, Shah D, Naik D, Chandan A, Sheth C, et al. A Late Coronary Stent Infection: Its Diagnosis and Surgical Treatment-A Case Report. Ann Cardiovasc Surg. 2018; 1(3): 1013.