{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:17:56Z","timestamp":1777299476182,"version":"3.51.4"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T00:00:00Z","timestamp":1627603200000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronary embolism is an important non-atherosclerotic cause of acute myocardial infarction (AMI) that requires an individualized diagnostic and therapeutic approach. Although certain angiographic criteria exist that render an embolic origin likely, uncertainty remains. Optical coherence tomography (OCT) is a high-resolution intracoronary imaging technology that enables visualization of thrombus and the underlying coronary vessel wall, which may be helpful to distinguish between an atherosclerotic and non-atherosclerotic origin of AMI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary\u2003<\/jats:title>\n                  <jats:p>A 50-year-old male was admitted with ongoing chest pain. Eleven years ago, he underwent implantation of a mechanical aortic valve prosthesis due to degenerated bicuspid valve with normal coronaries on preoperative angiography. The electrocardiogram showed anterior ST-segment elevation. Emergent angiography revealed total occlusion of the proximal left anterior descending artery (LAD). Thrombus was aspirated along with administration of intravenous glycoprotein IIbIIIa inhibitor. Except the apical part of the LAD showing distal embolization, coronary flow was completely re-established with no evidence of significant atherosclerosis. Stents were not implanted on the basis of the OCT finding, which demonstrated at the site of occlusion a normal vessel wall without atherosclerosis that could explain an erosion or plaque rupture event. Transoesophageal echocardiography confirmed a floating structure in the left ventricular outflow tract, suggesting that an embolus originating from the prosthetic aortic valve obstructed the LAD. The international normalized ratio 2 days prior to presentation measured 1.9.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion\u2003<\/jats:title>\n                  <jats:p>This case illustrates the utility of OCT to rule out the atherosclerotic aetiology of myocardial infarction and to avoid unnecessary stenting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab115","type":"journal-article","created":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T09:24:31Z","timestamp":1627637071000},"source":"Crossref","is-referenced-by-count":2,"title":["Coronary embolism due to possible thrombosis of prosthetic aortic valve - the role of optical coherence tomography: case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4044-4154","authenticated-orcid":false,"given":"Raminta","family":"Kavaliauskaite","sequence":"first","affiliation":[{"name":"Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7737-0374","authenticated-orcid":false,"given":"Tatsuhiko","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4630-9815","authenticated-orcid":false,"given":"Yasushi","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenz","family":"R\u00e4ber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,30]]},"reference":[{"key":"2021073009240655600_ytab115-B1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1161\/CIRCULATIONAHA.114.015134","article-title":"Prevalence, clinical features, and prognosis of acute myocardial infarction attributable to coronary artery embolism. Clinical perspective","volume":"132","author":"Shibata","year":"2015","journal-title":"Circulation"},{"key":"2021073009240655600_ytab115-B2","doi-asserted-by":"crossref","first-page":"3281","DOI":"10.1093\/eurheartj\/ehy285","article-title":"Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions","volume":"39","author":"R\u00e4ber","year":"2018","journal-title":"Eur Heart J"},{"key":"2021073009240655600_ytab115-B3","doi-asserted-by":"crossref","first-page":"2566","DOI":"10.1093\/eurheartj\/ehz332","article-title":"Clinical use of intracoronary imaging. Part 2; acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Interventions","volume":"40","author":"Johnson","year":"2019","journal-title":"Eur Heart J"},{"key":"2021073009240655600_ytab115-B4","doi-asserted-by":"crossref","first-page":"e005587","DOI":"10.1161\/CIRCINTERVENTIONS.117.005587","article-title":"Coronary embolism among ST-segment-elevation-myocardial infarction patients: mechanisms and management","volume":"11","author":"Popovic","year":"2018","journal-title":"Circ Cardiovasc Interv"},{"key":"2021073009240655600_ytab115-B5","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jcin.2017.08.057","article-title":"Coronary embolus: an underappreciated cause of acute coronary syndromes","volume":"11","author":"Raphael","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"2021073009240655600_ytab115-B6","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur Heart J"},{"key":"2021073009240655600_ytab115-B7","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1161\/CIRCULATIONAHA.116.025371","article-title":"Thrombus aspiration in ST-segment-elevation myocardial infarction: an individual patient meta-analysis: thrombectomy trialists collaboration","volume":"135","author":"Jolly","year":"2017","journal-title":"Circulation"},{"key":"2021073009240655600_ytab115-B8","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1093\/ehjci\/jes025","article-title":"Optical coherence tomography: from research to practice","volume":"13","author":"Guti\u00e9rrez-Chico","year":"2012","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021073009240655600_ytab115-B9","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1093\/eurheartj\/ehp433","article-title":"Review document on methodology, terminology, and clinical applications of optical coherence tomography: physical principles, methodology of image acquisition, and clinical application for assessment of coronary arteries and atherosclerosis","volume":"31","author":"Prati","year":"2010","journal-title":"Eur Heart J"},{"key":"2021073009240655600_ytab115-B10","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/ejechocard\/jeq045","article-title":"Recommendations for echocardiography use in the diagnosis and management of cardiac source of embolism","volume":"11","author":"Pepi","year":"2010","journal-title":"Eur J Echocardiogr"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/7\/ytab115\/39458469\/ytab115.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/7\/ytab115\/39458469\/ytab115.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T09:24:41Z","timestamp":1627637081000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab115\/6330926"}},"subtitle":[],"editor":[{"given":"Julien","family":"Adjedj","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Rafal","family":"Wolny","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Parham","family":"Eshtehardi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Max","family":"Sayers","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ross","family":"Thomson","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,7,1]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab115","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7,1]]},"published":{"date-parts":[[2021,7,1]]},"article-number":"ytab115"}}