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Successful removal of a paradoxical coronary embolus using an aspiration catheter

Nature Clinical Practice Cardiovascular Medicine volume 3, pages 633–636 (2006)Cite this article

Abstract

Background A 28-year-old man presented at hospital with persistent pain in his chest and left arm, a paced rhythm on electrocardiography and elevated levels of cardiac enzymes. He was known to have patent foramen ovale and a dual-chamber pacemaker, which had been implanted following electrophysiological ablation to treat supraventricular tachycardia 3 years previously. The patient did not have a history of cardiovascular risk factors, recent travel, immobilization or clinical features of infection, and he was not taking any medication.

Investigations Electrocardiography, cardiac enzyme studies, coronary angiography and transthoracic echocardiography.

Diagnosis Acute myocardial infarction, paradoxical coronary embolus and patent foramen ovale.

Management Coronary aspiration embolectomy and systemic anticoagulation.

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Figure 1: A coronary angiogram showing a coronary embolus in the obtuse marginal branch of the left circumflex artery (arrow).
Figure 2: A coronary angiogram showing the obtuse marginal branch after removal of the embolus (arrow).
Figure 3: Sections of clot aspirated from the left circumflex artery.
Figure 4: A transthoracic echocardiogram showing a patent foramen ovale with spontaneous right-to-left blood flow (arrow).

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Authors and Affiliations

  1. fellows in interventional cardiology,

    Andrew M Wilson, Reza Ardehali, Todd J Brinton, Alan C Yeung & Randall Vagelos

  2. fellow in cardiovascular medicine,

    Andrew M Wilson, Reza Ardehali, Todd J Brinton, Alan C Yeung & Randall Vagelos

  3. Interventional Cardiology Professor of Medicine,

    Andrew M Wilson, Reza Ardehali, Todd J Brinton, Alan C Yeung & Randall Vagelos

  4. professor of medicine and Director of the Cardiac Care unit, Stanford University Medical Center, Stanford, CA, USA

    Andrew M Wilson, Reza Ardehali, Todd J Brinton, Alan C Yeung & Randall Vagelos

Authors
  1. Andrew M Wilson
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  2. Reza Ardehali
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  3. Todd J Brinton
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  4. Alan C Yeung
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  5. Randall Vagelos
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Corresponding author

Correspondence to Andrew M Wilson.

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The authors declare no competing financial interests.

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Wilson, A., Ardehali, R., Brinton, T. et al. Successful removal of a paradoxical coronary embolus using an aspiration catheter. Nat Rev Cardiol 3, 633–636 (2006). https://doi.org/10.1038/ncpcardio0681

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  • DOI: https://doi.org/10.1038/ncpcardio0681

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