Off-pump coronary artery bypass graft surgery after stent implantation in a patient with combined thrombophilic risk factors.

The case of coronary artery bypass graft surgery in a 51-year-old woman with a heterozygous form of factor V Leiden, prothrombin mutation G20210A and tumour necrosis factor-alpha -308 G-A associated with high lipoprotein(a) and homocysteinemia levels, as well as elevated factors VIIIc and IX, is presented. She suffered from recurrent episodes of venous thromboembolism and left anterior descending artery subtotal occlusion eight months after percutaneous transluminal coronary angioplasty and stent implantation.