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- W92586049 abstract "A 50-year-old man with a history of mitral valve replacement because of rheumatic heart disease presented with a 2-hour history of severe mid-sternal chest discomfort, diaphoresis, and vomiting. The patient had stopped taking warfarin 1 month earlier. He had a pulse rate of 140 beats/min, blood pressure of 105/65 mmHg, and an irregularly irregular heart beat on auscultation. Electrocardiography revealed atrial fibrillation and acute anterolateral ST-segment-elevation myocardial infarction (Fig. 1). Results of diagnostic cardiac catheterization (Figs. 2–4) led us to refer the patient for emergent on-pump removal of a thrombus from the left main coronary ostium (Fig. 5). Despite a left ventricular ejection fraction of 0.15, the patient was well enough to be discharged to a rehabilitation center on postoperative day 39.Fig. 1 A 12-lead electrocardiogram reveals atrial fibrillation with ST-segment elevation in leads I, aVL, and V1 through V6, consistent with an acute anterolateral ST-elevation myocardial infarction.Fig. 2 Selective right coronary artery angiogram shows a normal coronary artery with no collateral vessels to the left coronary arteries.Fig. 3 Selective left coronary artery angiogram (30° left anterior oblique view) shows occlusion of the left main coronary artery (arrow) and the tilting-disc metallic prosthetic mitral valve.Fig. 4 Aortogram shows occlusion of the left main coronary artery and a mobile thrombus protruding from that artery into the aorta (white arrow), and the patent right coronary artery (black arrow).Fig. 5 A 2.8 × 0.6-cm brown tissue fragment with pathologic diagnosis of thrombus was retrieved from the left main coronary ostium." @default.
- W92586049 created "2016-06-24" @default.
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- W92586049 date "2012-01-01" @default.
- W92586049 modified "2023-09-23" @default.
- W92586049 title "Surviving a rare event: left main coronary artery occlusion." @default.
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