Perioperative management of coronary artery stents in South Africa

Abstract

Patients who receive a drug-eluting coronary artery stent (DES) will be placed on dual antiplatelet therapy (DAPT) for a period of six months to a year to prevent platelet activation and thrombosis of the stent. Non-cardiac surgery should be delayed until the patient has completed DAPT. If surgery has to be performed before the stipulated time required for DAPT, a multidisciplinary approach should be taken, involving a cardiologist, surgeon and anaesthetist. Stopping DAPT and risking stent failure must be weighed up against the risks of expected surgical bleeding. All patients who are scheduled for surgery within the stipulated period, should be managed perioperatively in a high dependency unit and in a hospital where 24-hour catheterisation laboratory (cath lab) services are available.