Abdul Haseeb, Muhammad Bilal, Med Ansari M Ahmed, Mudassir Iqbal Dar.
Embolic coronary artery occlusion in a patient with mitral valve replacement.
Pak Heart J Jan ;50(3):194-6.

Embolic occlusion of a coronary artery subsequent to mitral valve replacement is a 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 eighteen months after MVR. The patient discontinued her anti-coagulants, as a result she developed sub therapeutic International normalized ratio of 1.45. The angiogram revealed triple vessel disease with complete occlusion of Left Main Coronary Artery. Due to the deterioration of general condition, hemodynamic instability and extensive occlusion of multiple coronary arteries, plan was made to operate the patient for coronary artery bypass grafting surgery. This case report highlights the importance of continuation of anti-coagulant therapy and management of multi-vessel lesion by coronary artery bypass grafting surgery.

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