Unexpected stent thrombus after minimally invasive direct coronary artery bypass in hybrid re-vascularisation.

The progress in anti-platelet therapy and percutaneous coronary intervention led to reconfigure indications of hybrid re-vascularisation. However, there are still some controversies over indication, timing and patient management during the procedure. The case discussed here is a patient who was diagnosed with myocardial infarction and treated with hybrid re-vascularisation. The patient underwent stent insertion followed by bypass surgery. After the hybrid procedure, the patient was stable but eventually died on the 12th day after the surgery owing to unexpected stent thrombosis. We discuss the current controversy over hybrid re-vascularisation, variables that can affect the outcome and the requirement for establishing accurate logistics based on our case.