Acute left main occlusion secondary to embolisation from an aortic valve prosthesis: successful treatment with

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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

Isuru Ranasinghe, John Yiannikas, David Brieger

    International Journal of Cardiology
    |June 19, 2009
    PubMed

    Insights

    A rare case of left main coronary artery occlusion caused by aortic valve prosthesis emboli occurred in a patient who stopped warfarin. Successful treatment involved clot aspiration and stenting, leading to full recovery.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Cardiovascular Surgery

    Background:

    • Acute left main coronary artery occlusion is a rare and often fatal event.
    • Aortic valve prostheses can be a source of embolic events.
    • Warfarin cessation increases the risk of thromboembolism in patients with mechanical heart valves.

    Observation:

    • A 59-year-old patient with an aortic valve prosthesis presented with cardiogenic shock after discontinuing warfarin.
    • Coronary angiography revealed acute left main coronary artery occlusion due to emboli originating from the aortic valve prosthesis.

    Findings:

    • Successful treatment was achieved through clot aspiration embolectomy.
    • Percutaneous coronary angioplasty and stenting were performed following embolectomy.
    • The patient experienced excellent recovery of myocardial function and remained well at 6-month follow-up.

    Implications:

    • This case highlights the importance of anticoagulation in patients with aortic valve prostheses.
    • Early diagnosis and intervention are crucial for managing left main coronary artery occlusion.
    • Mechanical embolectomy and percutaneous coronary intervention offer a viable treatment option for prosthesis-related coronary emboli.

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