title: Acute coronary artery bypass graft failure in a patient with polycythemia vera.
abstract: 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.
authors.affiliation: Department of Cardiovascular Surgery, Mitsubishi Kyoto Hospital, Japan osahiro@kuhp.kyoto-u.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Osada
authors.affiliation: Department of Cardiovascular Surgery, Mitsubishi Kyoto Hospital, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakajima
authors.affiliation: Department of Cardiovascular Surgery, Mitsubishi Kyoto Hospital, Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Meshii
authors.affiliation: Department of Cardiovascular Surgery, Mitsubishi Kyoto Hospital, Japan.
authors.forename: Motoaki
authors.initials: M
authors.lastname: Ohnaka
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D011087:Polycythemia Vera / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors; D017211:Treatment Failure
keywords: Coronary artery bypass; percutaneous coronary intervention; polycythemia vera; thromboembolism