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Coronary Venous Graft Stent Infection With Mycotic Aneurysm Formation
Michael Hii1, Richard Lin1, Joseph Waugh1
1Royal Adelaide Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, Australia.
JACC. Case Reports
|March 21, 2025
Summary
Coronary stent infection is a rare but serious complication after cardiac procedures. Early diagnosis using advanced imaging and a team approach is crucial for managing this high-mortality condition.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
- Coronary stent infection is an exceptionally rare complication following PCI.
- This complication is associated with significant morbidity and mortality.
Observation:
- A 75-year-old woman presented with non-ST-segment elevation myocardial infarction and underwent PCI.
- She later developed symptoms of infection, with Staphylococcus aureus identified in blood cultures.
- Multimodality imaging confirmed coronary stent infection and mycotic aneurysm formation.
Findings:
- The patient required redo cardiac surgery due to the mycotic aneurysm.
- Diagnosis of coronary stent infection necessitates a high index of suspicion.
- Multimodality imaging and a multidisciplinary approach are essential for management.
Implications:
- Coronary stent infections carry a high mortality rate, ranging from 18% to 44%.
- Local complications, such as mycotic aneurysm formation, contribute to the high mortality.
- Prompt diagnosis and comprehensive management strategies are critical for improving patient outcomes.
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