Coronary embolism following aortic and mitral valve replacement: successful management with abciximab and urokinase.

We report a case of coronary embolism in a 63-year-old woman with St. Jude aortic and mitral valve replacements who presented with acute myocardial infarction. Urgent catheterization revealed a saddle embolus in the proximal part of the circumflex and ramus arteries and another embolus in a diagonal branch. After employing angioplasty for the totally occluding diagonal embolus, a combined regimen of intracoronary urokinase and intravenous abciximab was successful in achieving complete resolution of the emboli.