Mendoza Cesar E, Ferreira Alexandre C, de Marchena Eduardo
Division of Cardiology, Jackson Memorial Hospital, University of Miami School of Medicine, Miami, Florida 33136, USA.
J Heart Valve Dis. 2004 Jan;13(1):22-4.
Myocardial infarction (MI) due to coronary artery embolization is a rare and potentially lethal complication of prosthetic heart valve thrombosis. A 58-year-old man in whom the aortic valve was replaced with a bileaflet mechanical valve presented with an acute anterior MI. Valvular dysfunction was detected by physical examination, and confirmed by two-dimensional echocardiography and cinefluoroscopy. Coronary angiography disclosed embolization of the left anterior descending artery. Thrombotic encroachment of one of the prosthetic valve leaflets was found at reoperation. Failure to achieve adequate anticoagulation was likely due to an interaction between warfarin and herbal products. These findings have significant implications regarding the diagnosis and treatment of acute MI in patients with left-sided prosthetic heart valves, and emphasizes the importance of appropriate anticoagulation in this setting.
冠状动脉栓塞所致心肌梗死是人工心脏瓣膜血栓形成的一种罕见且可能致命的并发症。一名58岁男性，其主动脉瓣被双叶机械瓣膜置换，出现急性前壁心肌梗死。体格检查发现瓣膜功能障碍，并经二维超声心动图和荧光透视证实。冠状动脉造影显示左前降支动脉栓塞。再次手术时发现人工瓣膜的一个瓣叶有血栓性侵犯。未能实现充分抗凝可能是由于华法林与草药产品之间的相互作用。这些发现对左侧人工心脏瓣膜患者急性心肌梗死的诊断和治疗具有重要意义，并强调了在这种情况下适当抗凝的重要性。
