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Acute myocardial infarction in a patient with active actinic rectitis bleeding: Between the sword and the wall
Author(s) -
Manuel Valdano,
Steffen Samuel P.,
Gaiotto Fábio A.,
Puig Luiz B.
Publication year - 2019
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14102
Subject(s) - medicine , cardiology , heparin , artery , myocardial infarction , angina , percutaneous coronary intervention , unstable angina , surgery
A The coronary artery bypass graft (CABG) is common. Sometimes can be challenging. Here we present a 79‐year‐old man presented with unstable angina and simultaneous activelower gastrointestinal bleeding (hemoglobin level, 5.1 g/L) due to actinic rectitis after radiation therapy for prostate carcinoma performed 1 year previously. Coronary angiography showed marked stenosis of the left anterior descending artery. Antiplatelet aggregation therapy, such as percutaneous coronary intervention or systemic heparin therapy for coronary artery bypass, was not feasible owing to the active rectal bleeding. Therefore, off‐pump CABG has performed without systemic heparin therapy and the patient recovered well. For specific cases, CABG without systemic heparin therapy can be safely performed.