Mitral valve surgery with surgical embolectomy for mitral valve endocarditis complicated by septic coronary embolism

Man Jong Baek, Hyun Koo Kim, Cheol Woong Yu, Chan Young Na

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Acute myocardial infarction (AMI) complicated by septic coronary embolism due to active infective endocarditis is rare but usually fatal. We report a case of successful mitral valve surgery with surgical embolectomy in a 27-year-old man with an AMI complicated by septic coronary embolism due to mitral valve endocarditis. A chest radiograph revealed cardiomegaly and marked pulmonary edema. A transthoracic echocardiogram disclosed severe mitral regurgitation with highly mobile vegetations and hypokinesia of the left ventricular apex. The electrocardiographic findings of ST segment elevation in leads V2-4 and elevated cardiac enzyme levels were strongly suggestive of an acute anterolateral AMI. Nevertheless, emergent cardiac surgery was needed without selective coronary angiography because of intractable heart failure and life-threatening ventricular tachyarrhythmia requiring cardiopulmonary resuscitation. A total occlusion of the distal left anterior descending artery caused by embolic vegetation and thrombus, which was incidentally detected intraoperatively, was successfully recanalized by surgical embolectomy and thrombectomy using a direct coronary incision. The mitral valve endocarditis was managed with wide debridement and mechanical valve replacement. Three years after the surgery a follow-up echocardiogram showed no abnormalities of the regional wall, motion in the left ventricle and the patient is living an active life without any complications.

Original languageEnglish
Pages (from-to)116-118
Number of pages3
JournalEuropean Journal of Cardio-thoracic Surgery
Volume33
Issue number1
DOIs
Publication statusPublished - 2008 Jan
Externally publishedYes

Keywords

  • Acute myocardial infarction
  • Coronary embolism
  • Embolectomy
  • Endocarditis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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