# Embolization of left anterior descending artery due to pledget after a redo surgery

## TL;DR

A man developed a heart artery blockage after a pledget from a previous aortic valve surgery embolized, highlighting a rare surgical complication.

## Contribution

This case report highlights the risk of pledget embolization during redo aortic surgeries.

## Key findings

- A pledget from a prior aortic valve replacement embolized to the left anterior descending artery.
- The embolus was successfully removed using a snare catheter.
- The case emphasizes potential complications from pledgets in redo valve surgeries.

## Abstract

A 53-year-old man underwent aortic root replacement for acute aortic dissection. Following this procedure, the patient developed a pseudoaneurysm at the aortic root, necessitating reoperation. The subsequent surgery was performed routinely, allowing the patient to be weaned from mechanical ventilation on the same day. Postoperative electrocardiography revealed ST-segment elevation, suggesting myocardial ischaemia. Coronary angiography identified 90% stenosis in the left anterior descending artery, and computed tomography revealed a high-density mass. These findings suggested an embolus from a previous surgery. A snare catheter was successfully employed to extract the embolic material, which was identified as a pledget used for aortic valve replacement in the initial operation. This case underscores the potential for complications associated with pledgets used in valve surgeries, illustrating the risk of embolization when the valve is subsequently removed.