Coronary embolism following aortic and mitral valve replacement: successful management with abciximab and urokinase.
We report a case of coronary embolism in a 63-year-old woman with St. Jude aortic and mitral valve replacements who presented with acute myocardial infarction. Urgent catheterization revealed a saddle embolus in the proximal part of the circumflex and ramus arteries and another embolus in a diagonal branch. After employing angioplasty for the totally occluding diagonal embolus, a combined regimen of intracoronary urokinase and intravenous abciximab was successful in achieving complete resolution of the emboli.
Quinn
E G
EG
Internal Medicine Residency Program, University of Hawaii, Honolulu, USA.
Fergusson
D J
DJ
D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001021:Aortic Valve / Q000601:surgery; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D010960:Plasminogen Activators / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator; D000077284:Abciximab