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Ann Thorac Surg 2004;78:756-757
© 2004 The Society of Thoracic Surgeons

Correspondence

Is stenting an option?

Frank A. Baciewicz, Jr, MD, Nitin Kher, MD

Department of Cardiothoracic Surgery, Wayne State University/Harper Hospital, 3990 John R, Suite 2102, Detroit, MI 48201, USA

e-mail: fbaciewi{at}dmc.org

To the Editor:

We enjoyed the case report by Dr Sugimoto and colleagues [1] about rupture of the right coronary ostium as a result of blunt trauma. Was coronary arteriography considered shortly after repair of the acute injury? The anatomy suggests that stent placement might have been a possible intervention after the repair (with the requirement of an antiplatelet agent). Two case reports [2, 3] published in 2002 demonstrate that covered stents can be deployed successfully for atherosclerotic right and left giant coronary aneurysms. Stent placement might have eliminated the urgency of a second definitive surgical procedure or allowed elective repair.

The age of the patient, the proximity of the initial tear to the right ostium, and the large, dominant right coronary artery might have made one lean toward surgical revascularization. Was placement of a polytetrafluoroethylene-covered stent considered in this patient?

References

  1. Sugimoto S., Yamauchi A., Kudoh K., Hayakawa M., Igarashi Y., Tanaka T. A successfully treated case of blunt traumatic right coronary ostium rupture. Ann Thorac Surg 2003;75:1001-1003.[Abstract/Free Full Text]
  2. Lopez-Meneses M., Alfonso F., Fernandez-Ortiz A., et al. Treatment of a giant coronary aneurysm with a novel technique: scaffolding (tunnel) stenting to support PTFE-covered stents: insights from intravascular ultrasound. J Invasive Cardiol 2002;14:273-276.[Medline]
  3. Kereiakes D.J., Broderick T.M., Howard W.L., Anderson L.C., Weber M., Mitts D.L. Successful long-term therapy following saphenous vein–covered stent deployment for atherosclerotic coronary aneurysm. Catheter Cardiovasc Interv 2002;55:100-104.[Medline]




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