BULKY AND TUBULAR INTRACORONARY THROMBOSIS: INTRAOPERATIVE THROMBECTOMY AND CORONARY ARTERY BYPASS GRAFTING

A 46 year-old man with a history of hyperlipidemia was admitted with acute anterior ST-segment
elevation MI and his ejection fraction was 30%. He had rest typical chest pain despite routine and
complete medical treatment. Urgent coronary catheterization revealed complete occlusion in the
proximal of LAD artery with bulky thrombosis (TIMI flow =0-1). Complete thrombosuction and
primary PCI was not possible. Urgent three graft CABG was done due to symptoms of patient and
unsuccessful PCI.
Total lumen of LAD and diagonal arteries were full of clot. Large and tubular clots of LAD and diagonal
were removed with endarterectomy spatula, irrigation with heparinized saline and retrograde coronary
perfusion via coronary sinus catheter. Postoperative period was uneventful.
This patient was very rare case due to intracoronary thrombectomy via surgery and also due to bulky
and large clot that involved all way of coronary arteries. Similar cases were not found in different
literatures