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Unexpected stent thrombus after minimally invasive direct coronary artery bypass in hybrid re-vascularisation
Jae Hoon Shim1, Won-Min Jo, Won Jae Chung
1Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University Medical Center, Korea University, Gojan-1-dong, Ansan-si, Kyonggi-do 425-707, South Korea.
Insights
Hybrid re-vascularisation for myocardial infarction can be complex. A case of stent thrombosis after hybrid procedures highlights the need for careful patient management and logistics.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Advancements in anti-platelet therapy and percutaneous coronary intervention have shifted hybrid re-vascularisation indications.
- Controversies persist regarding optimal indications, timing, and patient management for hybrid procedures.
Observation:
- A patient with myocardial infarction was treated with hybrid re-vascularisation, involving stent insertion followed by bypass surgery.
- The patient remained stable post-procedure but experienced an unexpected death on the 12th post-operative day.
Findings:
- The patient's death was attributed to unexpected stent thrombosis occurring after the hybrid re-vascularisation procedure.
- This case underscores potential complications and challenges associated with hybrid re-vascularisation strategies.
Implications:
- Highlights the critical need for establishing accurate logistics and protocols for hybrid re-vascularisation.
- Suggests further investigation into factors influencing outcomes and preventing complications like stent thrombosis in hybrid procedures.
Abstract:
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.