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Submitted: 30 Mar 2021
Accepted: 10 Jun 2021
ePublished: 21 Jul 2021
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Immunopathol Persa. 2022;8(1): e5.
doi: 10.34172/ipp.2022.05
  Abstract View: 43
  PDF Download: 16

Case Report

Acute progressive arterial thrombosis after coronary artery bypass graft in a COVID-19 patient

Mahmoud Beheshti Monfared 1 ORCID logo, Hamid Ghaderi 1 ORCID logo, Zahra Ansari Aval 1 * ORCID logo, Seyedeh Adeleh Mirjafari 2 ORCID logo

1 Cardiovascular Research Center, Department of Cardiovascular Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Pediatrics, Ali-Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran
*Correspondence to Zahra Ansari Aval, Email: z.ansari@sbmu.ac.ir

Abstract

The longer the SARS-CoV-2 pandemic takes, the greater the prothrombotic effects of the disease, which varies from venous thromboembolic events to limb arterial thrombosis and stroke. How we deal with the effects of the COVID-19 disease, is still unclear. In this study, researchers will report the clinical presentation, outcome and management of the patient with COVID-19 after coronary artery bypass graft (CABG) surgery, which led to rapid progression of arterial thrombosis. The COVID-19 positive patient underwent emergency CABG, due to developed coronary artery disease. Despite receiving high-dose preoperative Plavix and heparin and also postoperative aspirin, the patient developed progressive thrombosis in both lower extremities 4 days after surgery. It then spread to bilateral iliac arteries, aorta, abdominal and renal artery. Femoral endarterectomy was performed two times for atheromatous plaque removal which was unsuccessful and the patient died few days later due to multi-organ failure. COVID-19 is a risk factor for arterial thrombosis with high mortality and morbidity rate. If thrombosis happens, the prognosis will be poor. Comprehensive treatments have to be started immediately after diagnosis. In patients undergoing surgery for extensive arterial thrombosis due to poor prognosis, not only surgical revascularization is needed but also thrombolysis treatments may be considered as off-label use. As the pandemic continues, new approaches and interventions may be applied.
Keywords: COVID-19, Acute, Arterial, Thrombosis, Heart surgery, Acute limb, Ischemia
Citation: Beheshti Monfared M, Ghaderi H, Ansari Aval Z, Mirjafari SA. Acute progressive arterial thrombosis after coronary artery bypass graft in a COVID-19 patient. Immunopathol Persa. 2022;8(1):e05. DOI:10.34172/ ipp.2022.05.
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