Left Anterior Descending Artery (LADA) 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 a anterior STEMI and managed with aggressive pharmacotherapy.

Petar Nikolov completed his PhD at the age of 31 years from Medical University – Plovdiv, Bulgaria He is one of three main examinators for students of IVth year in the field of Cardiology in Medical University-Plodiv. He has over 50 publications that have been cited over 20 times, and his publication h-index is 5. He has been serving as an editorial board member of several reputed journals.