The Correct Answer is C!
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A 68 year-old man plans to have a total hip arthroplasty for severe degenerative joint disease of the hip. His history is noteworthy for coronary artery disease with myocardial infarction, percutaneous coronary intervention (PCI) with drug-eluting coronary stent placement 2 months ago, controlled hypertension, tobacco use, chronic obstructive pulmonary disease with bronchospasm, chronic kidney disease, and obesity. The patient has been clinically stable since the PCI. Current medications are diltiazem, metoprolol, isosorbide mononitrate, clopidogrel, acetylsalicylic acid (ASA), and albuterol metered-dose inhaler. Physical examination is noteworthy for obesity and diminished cardiac and pulmonary sounds.
When should this surgery be performed?
- After stopping the use of clopidogrel for 14 days while continuing ASA
- Three months after PCI, placement of drug-eluting stent, and continous DAPT
- More than 12 months after PCI, placement of a drug-eluting stent, and continuous dual anti-platelet therapy (DAPT)
- Six months after PCI, placement of drug-eluting stent, and continuous DAPT
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1. Source: "Comparative Analysis of Pre/Post Assessments of Live/Didactic Course Attendees when compared to Mico-Learning/Online Course Users., "Knowledge to Practice, 2017.