ArticleJACC. Case reports2026
Embolic MINOCA From Mechanical Aortic Valve Thrombosis: A Potential Role of Prosthesis-Patient Mismatch.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundCoronary embolism is a rare cause of MINOCA (myocardial infarction with nonobstructive coronary arteries), particularly in patients with mechanical aortic prosthesis. CASE SUMMARY: A 64-year-old woman who underwent prior double mechanical valve replacement and had chronic aortic prosthesis-patient mismatch presented with myocardial infarction. Coronarography showed nonobstructive arteries. Multimodality imaging demonstrated a small transmural apical infarction and restricted leaflet motion along with a thrombus in the aortic prothesis. Despite therapeutic anticoagulation, a transient coronary embolic event from prosthetic thrombosis was considered the likely mechanism. The patient underwent redo aortic valve replacement with a larger prosthesis, resulting in favorable clinical and hemodynamic recovery. DISCUSSION: Few studies suggest the role of prosthesis-related factors, including prosthesis-patient mismatch, in mechanical valve thrombosis and embolic MINOCA. TAKE-HOME MESSAGES: In MINOCA with mechanical valves, coronary embolism should be suspected. Prosthesis-patient mismatch may contribute to thrombotic risk beyond anticoagulation status.
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