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Takehiro Wakasugi, Yoichi Matsuo* and Hiromitsu Takeyama
A 71-year-old man was admitted for acute myocardial infarction. The occluded right coronary artery was immediately reperfused by balloon angioplasty during percutaneous coronary intervention and plans were made to stent the left anterior descending artery and circumflex branch at a later date. Anti-platelet therapy was started after intervention. Ten days after intervention, the patient developed hematemesis. An advanced gastric cancer was identified as the source of the bleed. Although an urgent gastrectomy was indicated, the remaining coronary artery stenoses complicated surgical management.
The decision was made to perform the second intervention prior to gastrectomy and to treat the remaining stenoses with bare metal stents. Two months after the second intervention, a total gastrectomy was performed under general anesthesia. No severe cardiac complications occurred during the postoperative period.