1. SURGERY EARLY AFTER DES IMPLANTATION
THERAPEUTIC IMPLICATIONS
It depends on which surgery
Giuseppe Biondi-Zoccai
Division of Cardiology, University of Turin,
20/10/

2. Timing from DAT withdrawal and ST
Artang et al, AJC 2007

3. Temporal risk from PCI to surgery
Cruden et al, Circ Cardiovasc Interv 2010

4. Predictors of stent thrombosis
Grines et al, Circ 2007

5. Ischemic risk of surgery
Fleisher et al, Circ 2007

6. Bleeding risk of surgery
O’Riordan et al, Arch Surg 2009

7. ESC Guidelines
Wijns et al, EHJ 2010

8. Balancing bleeding & ischemic risk
Heart, Lung and Circulation 2010

9. Management of patients needing surgery
Di Minno et al, Intern Emerg Med 2009

10. Bridging therapy
Savonitto et al, BJA 2010

11. Bridging therapy
Savonitto et al, BJA 2010

12. What to do if bleeding occurs?
O’Riordan et al, Arch Surg 2009

13. Continue DAT in all but few cases
Take home messages
Individualize treatment depending on bleeding risk, ischemic risk and surgeon’s skills
Continue DAT in all but few cases
If DAT cannot be enforced, use bridging therapy plus aspirin

14. Thank you for your attention For any correspondence: For these and further slides on these topics feel free to visit the metcardio.org website: