Acute Coronary Embolism without Valve Thrombosis in a Patient with a Prosthetic Mitral Valve—Successful Percutaneous Coronary Intervention: A Case Report

Authors

  • Mehmet Yazici
  • Mehmet Kayrak
  • Yasar Turan
  • Fatih Koc
  • Mehmet S. Ulgen

DOI:

https://doi.org/10.1532/HSF98.20071011

Abstract

We present a 44-year-old female patient with anterior myocardial infarction caused by embolization from mitral valve prosthesis due to inadequate anticoagulation. The patient underwent a cardiac catheterization within the 1st hour of arrival. The angiography showed total occlusion of the left anterior descending coronary artery after the second diagonal branch. Percutaneous transluminal coronary angioplasty and stenting were performed, and coronary artery perfusion was restored. The pain disappeared completely immediately after this intervention. Transthoracic echocardiography shortly after this intervention showed normal prosthetic valve function and no thrombus. Transesophageal echocardiography performed 2 days later revealed no thrombus at the prosthetic valve. In conclusion, this case demonstrated that coronary embolism may occur even without prosthetic valve thrombus or dysfunction with suboptimal International Normalized Ratio levels, and can be successfully treated with percutaneous transluminal coronary angioplasty and stenting.

References

Aslam MS, Sanghi V, Hersh S, et al. 2002. Coronary artery saddle embolus and myocardial infarction in a patient with prosthetic mitral valve. Cathet Cardiovasc Interv 57:367-70.nBurchart E, Payne N, Li H, et al. 2002. Better anticoagulation control improves survival after valve replacement. J Thorac Cardiovasc Surg 123:715-22.nCharles RG, Epstein EJ. 1983. Diagnosis of coronary embolism: a review. J R Soc Med 10:863-8.nEPIC Investigators. 1994. Use of monoclonal antibody direct against the platelet glycoprotein IIb/IIIa receptor in high-risk coronary angioplasty. N Engl J Med 330:956-61.nLarsen AI, Galbraith PD, Ghali WA, et al. 2005. Characteristics and outcomes of patients with acute myocardial infarction and angiographically normal coronary arteries. Am J Cardiol 95:261-3.nLefkovits J, Ivanhoe RJ, Califf RM, et al. 1996. Effects of platelet glycoprotein IIb/IIIa receptor blockade by a chimeric monoclonal antibody (abciximab) on acute and six-month outcomes after percutaneous transluminal coronary angioplasty for acute myocardial infarction. Am J Cardiol 77:1045-51.nMarti V, Romeo I, Garcia J, et al. 2000. Combined therapeutic strategy for multiple coronary thromboemboli. Cathet Cardiovasc Diagn 50:343-5.nMirza A. 2003. Myocardial infarction resulting from nonatherosclerotic coronary artery diseases. Am J Emerg Med 21:578-84.nPrizel KR, Hutchins GM, Bulkey BH. 1978. Coronary artery embolism and myocardial infarction. Ann Intern Med 88:155-61.nQuinn EG, Fergusson DJ. 1998. Coronary embolism following aortic and mitral valve replacement: successful management with abciximab and urokinase. Cathet Cardiovasc Diagn 43:457-9.nWegner NK, Bauer S. 1958. Coronary embolism review of literature and presentation of fifteen cases. Am J Med 25:549-57.nZijlstra F, de Boer MJ, Hoorntje JC, et al. 1993. A comparison of immediate coronary angioplasty with intravenous streptokinase in acute myocardial infarction. N Engl J Med 328:680-4.n

Published

2007-04-24

How to Cite

Yazici, M., Kayrak, M., Turan, Y., Koc, F., & Ulgen, M. S. (2007). Acute Coronary Embolism without Valve Thrombosis in a Patient with a Prosthetic Mitral Valve—Successful Percutaneous Coronary Intervention: A Case Report. The Heart Surgery Forum, 10(3), E228-E230. https://doi.org/10.1532/HSF98.20071011

Issue

Section

Article