Coronary embolism causing myocardial infarction after heart valve surgery

Preveden, Andrej; Kovacevic, M; Šušak, Stamenko; Redžek, Aleksandar; Velicki, Lazar

doi:10.2298/vsp180809180p

Cited by 4 publications

(1 citation statement)

References 9 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main cause of coronary thromboembolism is atrial fibrillation [27]. Although our patient was in sinus rhythm, she did have a few other risk factors, including previous cardiac surgery, non-infected thrombi on prosthetic valve, and intraluminal thrombosis inside the chronic dissection of the descending aorta, which are all described as rare but possible causes of coronary thromboembolism [27,28]. There is scarce data in literature describing coronary thromboembolism after Bentall operation [29,30].…”

Section: Discussionmentioning

confidence: 96%

Pregnant woman survives aortic dissection, dies later of coronary embolism - a unique case of a non-compliant patient

et al. 2019

Self Cite

View full text Add to dashboard Cite

Introduction The incidence of aortic dissection ranges 3-5 cases per 100,000 person-years. In women under the age of 40 who acquire aortic dissection, almost half of the cases happen during pregnancy. Case outline We report a case of a 22-year-old pregnant woman in the 16th gestational week with a history of arterial hypertension and known aortic dilatation, who was admitted with aortic dissection. She underwent the Bentall procedure, in which her aortic valve, ascending aorta, and proximal part of the aortic arch were replaced using valved composite graft. On the next day, the evacuation abortion was made, since the fetus didn't survive the operation. Six years later, the patient stopped taking anticoagulation therapy and was admitted for prosthetic valve thrombosis, which was successfully treated with intravenous heparin. One year later, the patient died of a myocardial infarction due to coronary thromboembolism, confirmed on autopsy. Conclusion Preconceptional counseling in women with a known aortic disease is of the utmost importance. Aortic dissection in pregnant women is an acute life-threatening condition for both mother and fetus that should be managed by a multidisciplinary team. After a mechanical heart valve implantation, lifetime oral anticoagulants are mandatory.

show abstract

Section: Discussionmentioning

confidence: 96%

Pregnant woman survives aortic dissection, dies later of coronary embolism - a unique case of a non-compliant patient

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

Free-floating right heart thrombus with pulmonary embolism - a case report

Majdevac,

Zdravkovic,

Preveden

et al. 2023

Med pregl

View full text Add to dashboard Cite

Introduction. Right heart thrombus is uncommon and it is usually detected by echocardiography in patients with venous thromboembolism. Thrombi attached to the atrial or ventricular wall have a good prognosis; however, free-floating ?snake-like? thrombi are usually associated with massive, unstable pulmonary embolism and high mortality. Case Report. A 43-year-old male patient visited a cardiologist complaining about rapid fatigue and shortness of breath with minimal effort in the last week. An echocardiographic examination confirmed a right heart thrombus and a pulmonary embolism. After the examination, the case was presented to the Heart Team, which made a decision to perform a surgery. After the usual preoperative preparation for emergency surgery, the patient underwent surgery under general endotracheal anesthesia via median sternotomy. Conclusion. The right heart thrombus is associated with risks of possible embolization to the pulmonary circulation and potential circulatory collapse. There was a considerable discrepancy between the apparently mild clinical presentation and the alarming echocardiographic finding of a huge free-floating thrombus. Despite the lack of standardized and precise recommendations for the optimal therapeutic strategy, surgical approach seems to be the best option in emergency cases with large free-floating thrombi.

show abstract

Prosthetic heart valve thrombosis - a headache for the heart team: A case report

Majdevac,

Preveden,

Dracina

et al. 2023

Med pregl

View full text Add to dashboard Cite

Introduction. Prosthetic valve thrombosis is usually a subacute or chronic condition, although it may also present with a fresh thrombus. It occurs in two forms: obstructive and non-obstructive thrombosis. Case Report. We present a case of a female patient who underwent mitral valve replacement with mechanical prosthesis due to severe mitral stenosis. The postoperative course was uneventful and the patient was discharged on vitamin K antagonist therapy with international normalized ratio target 3.0. Five months later, the patient was admitted with severe shortness of breath and signs of acute heart failure. International normalized ratio at that moment was 2.3. Transthoracic echocardiography indicated severely raised gradient across the prosthetic valve and mechanical valve malfunction was suspected. Cinefluoroscopy showed that one of the prosthetic valve leaflets was completely immobile. Transesophageal echocardiography definitely confirmed thrombosis of the prosthetic valve with large multiple thrombi that completely fixed one leaflet in closed position, and partially limited the motion amplitude of the other leaflet. There were thrombi floating between the left ventricle and left atrium. Thrombectomy of the prosthetic valve was performed, which was sufficient for the complete restoration of the mechanical valve function. The vitamin K antagonist dosage was carefully up-titrated in order to reach and maintain the target international normalized ratio of 3.0. Conclusion. Prosthetic valve thrombosis is a serious and life-threatening condition that requires urgent management. Coordination and cooperation of the whole heart team is necessary for optimal choice of treatment, which primarily includes surgery or fibrinolysis.

show abstract

Coronary embolism causing myocardial infarction after heart valve surgery

Cited by 4 publications

References 9 publications

Pregnant woman survives aortic dissection, dies later of coronary embolism - a unique case of a non-compliant patient

Pregnant woman survives aortic dissection, dies later of coronary embolism - a unique case of a non-compliant patient

Free-floating right heart thrombus with pulmonary embolism - a case report

Prosthetic heart valve thrombosis - a headache for the heart team: A case report

Contact Info

Product

Resources

About