Acute coronary artery bypass graft failure in a patient with polycythemia vera

Polycythemia vera in patients undergoing cardiac surgery is clinically rare. A 65-year-old man with polycythemia vera was admitted with effort-related chest discomfort. We planned coronary artery bypass grafting for left anterior descending artery and obtuse marginal branch stenosis, using bilateral internal thoracic arteries, with perioperative prophylactic management to avoid thromboembolism. His internal thoracic arterial grafts occluded during and after surgery due to thrombus, and ST-elevation myocardial infarction developed, which needed a percutaneous coronary intervention. This case suggests that optimal management methods should be studied further to contribute to better patient outcomes in this condition.