Key result
Manual thrombectomy restores coronary flow in a mechanical mitral valve patient with a coronary embolism.
Case Report (n=1)
Demonstrates the severe consequence of unmonitored VKA discontinuation in mechanical valve patients, presenting as coronary embolism successfully treated with manual thrombectomy.
Reinforces anticoagulation continuity in mechanical valve patients; single case leaves open thrombectomy role in coronary embolism.
Coronary embolism is a non-atherosclerotic cause of acute coronary syndromes. It is frequently observed in patients with atrial fibrillation or prosthetic heart valves. We report the case of a 40-year-old woman with no cardiovascular risk factors but a history of mechanical mitral valve replacement, who had discontinued her vitamin K antagonist (VKA) therapy without medical supervision. She presented with sudden-onset, typical anginal chest pain at rest, described as retrosternal pressure radiating to the left arm and associated with dyspnea. Transthoracic echocardiography revealed an abnormality on the mitral prosthesis, and transesophageal echocardiography confirmed the presence of a thrombus. Coronary angiography identified a subocclusive thrombotic lesion in the mid-left anterior descending (LAD) artery, consistent with coronary embolism. The patient underwent successful manual thrombectomy without stent implantation.
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Zaynab et al. (2025) conducted a case report in Coronary embolism (n=1). Manual thrombectomy was evaluated on Thrombus extraction and restoration of coronary flow. Manual thrombectomy successfully extracted the thrombus and restored normal coronary flow in a patient with a mechanical mitral valve who suffered a coronary embolism after discontinuing anticoagulation.
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