A 58-year-old man was admitted to our hospital because of continual chest pain. The coronary angiography showed severe stenosis of the mid LCX and mid RCA. He was administered dual-antiplatelet therapy and received an infusion of heparin and nitroglycerin. We performed elective percutaneous coronary intervention(PCI) for the mid LCX. Two PES(3.0/28＋3.5/16) were implanted on LCX. After stenting, coronary thrombus appeared suddenly. We performed intravascular ultrasound(IVUS) and recognized much of thrombus and no finding of dissection and stent malapposition. Platelets were not decreased. While plain old balloon angioplasty(POBA) was performed repeatedly under intra-aortic balloon pumping(IABP), coronary thrombus appeared. After argatroban was administered, coronary thrombus disappeared completely. We experienced a case which argatroban was clinically effective in spite of no evidence of heparin-induced thrombocytopenia.

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We here report a case of 28-year-old woman who received a percutaneous cardiopulmonary support(PCPS) under the diagnosis of fulminant myocarditis. She developed hematuria and hemolytic anemia due to failed drainage in the PCPS. After the exchange of the drainage tube to a larger size and simultaneous use of continuous hemodiafiltration, her cardiac function gradually improved. She discharged by walk from the hospital without complications 41 days after admission. Institution of PCPS secured by a sufficient flow with prevention of the complication could contribute to a full recovery in this patient with fulminant myocarditis.

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A 76-year-old man presented to our hospital with chest pain and dyspnea. Coronary angiography revealed a 90% stenosis in the left main trunk, 90% stenosis in the left circumflex artery, and total occlusion in the right coronary artery. He was also diagnosed as having severe renal dysfunction with serum Cr 3.93mg/dl, eGFR 12.5ml/min/1.73m² and Ccr 19.3ml/min. He underwent OPCAB, and carperitide was administered during the operation and continued until the 8 POD. The combined therapy of OPCAB and carperitide infusion were effective for protection of renal function during and after the operation. The urine output and renal function were maintained at the same level as the pre-operation values during and after the operation.

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