A case of late postoperative LMA/LAD area thrombosis and extensive anterior ST↑ MI

Left anterior descending artery (LAD) bypass via left internal mammary artery (LIMA) as an arterial graft in the cardiac surgical treatment of multivessel ischemic heart disease is the gold standard due to its long-term patency and durability compared to all other grafts. Acute LIMA thrombosis causing acute coronary syndrome is rare. Several cases of acute LIMA occlusion in the late postoperative period are described in the literature, as one of the patients died during the procedure  and the others undergoing successful percutaneous coronary intervention (PCI). Here we report a case of probable thromboembolic event in the LIMA graft area 8 years after CABG causing an anterior acute anterior myocardial infarction with ST elevation and managed with aggressive pharmacotherapy.