Abstract
We herein present our experience with tooth extraction performed in conjunction with intravenous sedation using midazolam while monitoring the patients' physical condition as general management for patients in the 1st and 3rd month after percutaneous coronary intervation (PCI) for myocardial infarction.
Concerned with the commencement of dental treatment for postmyocardial infarction patients, it is generally postulated in clinical practice that within 6 months from onset of myocardial infraction symptoms, invasive procedures are contraindicated or only symptomatic treatments are permissible. In the two cases that we describe herein, treatments were performed since the Division of Cardiovascular Disease evaluated that the patients' cardiac function was stable after receiving PCI, the dental treatment was postponed for six months after the onset of myocardial infraction symptoms or it would have interfered with the patients' daily life. PCI is possible under local anesthesia and its surgical stress is relatively small, so as to the result, early recovery can be expected. Furthermore, with the use of stents, reduction (decrease) in risk of reinfarction can be speculated. In both cases, there were no deterioration in cardiac function, difficulty in maintaining hemostasis and postoperative hemorrhage (bleeding) observed during and after the operation, and satisfactory results were obtained.
It is of major importance that the medical planning for patients with myocardial infarction, whose number is speculated to increase in the future, be taken into account during consultation by the presiding doctors for the improvement of the patients' quality of life and their general condition.
