Title : Late presentation of right coronary artery stent infection as left empyema and pleuro-pericardial fistula
Abstract:
Background: Coronary stent infections are rare but a potentially life-threatening disease, the incidence of which has been on a rise over the last two decades.
Method: We report a case who presented with symptoms of heart failure and shock. Patient was stabilized and diagnosed as a complicated (empyema with pleuro-pericardial fistula) case of coronary stent infection. He was treated by stent removal and decortication.
Discussion: Early recognition and institution of appropriate medical and surgical therapy is vital for patient survival. Blood culture and coronary angiography are the preferred diagnostic modalities followed by PET scan and cardiac MRI for delineating the extent.
Conclusion: Surgery seems the treatment of choice, providing a definitive diagnosis of CSI and removing the source of infection, repairing aneurysms, and providing bypass vascular grafts if feasible. Thorough evaluation and multidisciplinary approach with institution of appropriate medical and surgical therapy lead to detection and better outcome.
Audience Take Away Notes
Current status of coronary stent infections
Treatment algorithms for the pathology
Approach for treatment
