[Coronary stent implantation: infection and abscess with fatal outcome]

Abstract

We report a case of coronary stent-implantation using a Palmaz-Schatz-stent in the right coronary artery (RCA) of a 66-year old woman. Coronary stenting was performed following local dissection and high-grade stenosis after PTCA. Following stent thrombosis re-PTCA was successful, but within 4 weeks progressive reduction of the patient's general condition, plus leucocytosis, subfebril temperatures, and a pericardial effusion occurred. Transesophageal echocardiography documented a perivascular myocardial abscess near the RCA stent; puncture demonstrated pericardial empyema. Emergency cardiac operation was done with segmental resection of the destructed RCA, stent explantation, and CABG to the peripheral RCA, but the patient died. To our knowledge, this is the first case of stent infection reported in the international literature. Transesophageal echocardiography was very helpful in diagnosing this fatal complication of coronary stenting.