EMBOLIC CORONARY ARTERY OCCLUSION IN A PATIENT WITH MITRAL VALVE REPLACEMENT

Abstract

Embolic occlusion of a coronary artery subsequent to mitral valve replacement isa rare condition with undocumented incidence. Here we present a case of 55-year-old female, ex-smoker, with complain of sudden onset of severe dyspnea,left sided chest pain and signs of decreased cardiac output within eighteenmonths after MVR. The patient discontinued her anti-coagulants, as a result shedeveloped sub therapeutic International normalized ratio of 1.45. The angiogramrevealed triple vessel disease with complete occlusion of Left Main CoronaryArtery. Due to the deterioration of general condition, hemodynamic instabilityand extensive occlusion of multiple coronary arteries, plan was made to operatethe patient for coronary artery bypass grafting surgery. This case reporthighlights the importance of continuation of anti-coagulant therapy andmanagement of multi-vessel lesion by coronary artery bypass grafting surgery. Key words: Embolic occlusion;Mitral valve replacement; Anti-coagulant therapy.