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Case reports

Unexpected stent thrombus after minimally invasive direct coronary artery bypass in hybrid re-vascularisation

Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University Medical Center, Korea University, Gojan-1-dong, Ansan-si, Kyonggi-do 425-707, South Korea

Received 17 February 2009; accepted 3 April 2009.

^_* Corresponding author. Tel.: +82 2 31 412 5060; fax: +82 2 31 414 3249. (Email: jowonmin{at}korea.ac.kr).

The progress in anti-platelet therapy and percutaneous coronary intervention led to reconfigure indications of hybrid re-vascularisation. However, there are still some controversies over indication, timing and patient management during the procedure. The case discussed here is a patient who was diagnosed with myocardial infarction and treated with hybrid re-vascularisation. The patient underwent stent insertion followed by bypass surgery. After the hybrid procedure, the patient was stable but eventually died on the 12th day after the surgery owing to unexpected stent thrombosis. We discuss the current controversy over hybrid re-vascularisation, variables that can affect the outcome and the requirement for establishing accurate logistics based on our case.

Key Words: Hybrid re-vascularisation • Percutaneous coronary intervention • Anti-platelet therapy