Deep Vein Thrombosis in A Post-Coronary Artery Bypass Grafting Patient: Successful Conservative Management

S H Sarker1, A K Miraj, M A Hossain

  • 1Dr Md Sanaul Hoque Sarker, MS Phase A Student, Department of Cardiovascular and Thoracic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

Insights

Deep vein thrombosis (DVT) is a rare post-coronary artery bypass grafting complication. Early diagnosis and combined anticoagulation with rivaroxaban and heparin led to rapid recovery in a 50-year-old diabetic patient.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Hematology

Background:

  • Deep vein thrombosis (DVT) involves blood clot formation in deep veins, often asymptomatic.
  • Post-coronary artery bypass grafting (CABG) DVT is particularly rare in Asian populations.
  • DVT symptoms can mimic musculoskeletal disorders, delaying diagnosis.

Observation:

  • A 50-year-old diabetic male post-CABG presented with left leg swelling, fever, and calf pain.
  • Clinical signs included absent pedal pulse, positive Homan sign, and a Wells score of 7.
  • Duplex study confirmed popliteal deep vein thrombosis with recanalization.

Findings:

  • The patient received meticulous treatment including bed rest, limb elevation, heparinization, and oral rivaroxaban.
  • Rapid recovery was observed following the combined therapeutic approach.
  • Anemia of chronic disease due to hemorrhoids was a co-existing condition.

Implications:

  • Post-CABG patients benefit from prophylactic anticoagulation (enoxaparin or heparin) for 3-5 days.
  • Prompt diagnosis of DVT is crucial for reducing patient morbidity.
  • Combined rivaroxaban and heparin therapy shows significant clinical value for post-CABG DVT.

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