Coronary stent implantation can rarely lead to severe infectious complications such as suppurative pancarditis.
Rare post-stent infectious pancarditis warrants clinical vigilance in febrile patients; leaves open true incidence and prevention strategies.
We diagnosed angiographically a greater than 90% stenosis of the left anterior descending artery (LAD) in a 54 year old man. The LAD stenosis was dilatated because the patient had Canadian Cardiovascular Society class III angina pectoris; a 15 mm Micro-stent (AVE Inc, Santa Rosa, California, USA) was implanted because of insuYcient dilatation. A dissection distal to the stent was treated successfully with a second Micro-stent. Four days after uncomplicated stent implantation the patient had an acute anterior myocardial infarction caused by a proximal LAD occlusion. The recanalisation procedure was complicated twice by ventricular fibrillation terminated using self adhesive defibrillation patches. Over the next 72 hours the patient had high fever, leucocytosis, and increased C reactive protein. Two of four blood samples were positive for Staphylococcus aureus. The
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Grewe et al. (1999) studied this question.
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