Author + information
- Received May 16, 2017
- Revision received May 28, 2017
- Accepted June 7, 2017
- Published online December 18, 2017.
- Ali Dogan, MDa,∗ (, )
- Yelda Saltan, MDa,
- Behzat Ozdemir, MDa,
- Kenan Sever, MDb,
- Emrah Ozdemir, MDa,
- Denyan Mansuroglu, MDb,
- Payam Hacisalihoglu, MDc and
- Nuri Kurtoglu, MDa
- aDepartment of Cardiology, Faculty of Medicine, Gaziosmanpasa Hospital, Istanbul Yeni Yuzyil University, Istanbul, Turkey
- bDepartment of Cardiovascular Surgery, Faculty of Medicine, Gaziosmanpasa Hospital, Istanbul Yeni Yuzyil University, Istanbul, Turkey
- cDepartment of Pathology, Faculty of Medicine, Gaziosmanpasa Hospital, Istanbul Yeni Yuzyil University, Istanbul, Turkey
- ↵∗Address for correspondence:
Dr. Ali Dogan, Istanbul Yeni Yuzyil University, Faculty of Medicine, Gaziosmanpasa Hospital, Department of Cardiology, Gaziosmanpasa, Istanbul, Turkey.
A 54-year-old male patient with no history of left bundle branch block was admitted to the emergency department with chest pain lasting for 1 h. Electrocardiography demonstrated newly developed left bundle branch block indicating ST-segment elevation myocardial infarction. He was immediately taken to catheterization laboratory. Coronary angiography and aortography revealed 3-vessel disease and a huge thrombus in left sinus of Valsalva protruding into left main coronary artery (Figure 1A, Online Video 1). He had neither atrial fibrillation nor an enlarged left atrium at presentation or by history. His hemodynamic status deteriorated quickly and then he developed cardiopulmonary arrest. The patient was transferred to the operating room to undergo emergent coronary bypass grafting and thrombus removal surgery under cardiopulmonary resuscitation. During surgery, the thrombus was extracted from the left sinus of Valsalva (Figure 1B). The surgeons noted that the thrombus was adherent to the aortic valve with a small pedicle, suggesting in situ thrombosis rather than embolization. The valve was involved with the thrombotic process. The mass was subsequently histopathologically proven to be a thrombus (Figures 1C and 1D). Afterward, the patient was followed for 1 week and unfortunately died in the intensive care unit due to multiorgan failure.
Coronary artery embolism from native aortic valve thrombus is a very exceptional, yet possible case during primary percutaneous coronary intervention.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 16, 2017.
- Revision received May 28, 2017.
- Accepted June 7, 2017.
- 2017 American College of Cardiology Foundation