Objective: We report a case of a patient undergoing Open Coronary Artery Bypass Graft Surgery (CABG) with CytoSorb^® under dual antiplatelet therapy (DAPT) with a broken guidewire in RCA ostium.

Case Presentation: A 66-year-old male patient on doublet antiplatelet therapy of ticagrelor and ecospirin underwent percutaneous transluminal coronary angioplasty (PTCA) in lieu of Triple Vessel Disease (TVD). During withdrawal, guide wire was stuck in the right coronary artery ostium. Patient’s LVEF reduced to 40% with akinitic walls and early pulmonary edema. On-pump coronary artery bypass graft (CABG) surgery was performed using intraoperative CytoSorb^®.

Results: No post-operative bleeding was recorded. The patient demonstrated good pump function and sinus rhythm. The patient was discharged within 7 days of hospitalization including 3 days of ICU stay.

Conclusions: Intra-operative usage of CytoSorb^® during emergency cardiac surgery in-patient treated with anti-platelet agents is an effective option which reduces risk of bleeding complications, thereby improving outcomes, reducing cost and minimizing morbidity and mortality.