[Calcified embolism of the coronary artery due to the degeneration of a bioprosthesis in the aortic position].

We present a case of arterial coronary embolism by calcified material of a bioprosthesis of bovine pericardium of the INC in aortic position 8 years after its implantation. Echocardiogram and catheterization with coronarography demonstrated prosthetic aortic dysfunction and normal coronaries. The patient complained of stable angor and dyspnea. During coronarography there was an increase of symptoms together with ECG changes and after a few hours with enzymatic increase. The patient was brought urgently to surgery where mitroaortic prosthesis was changed with mechanic prosthesis. As surgical findings: absence of a leaflet of prosthesis in aortic position with free fragmented calcium in periannular region and two remaining leaflet completely calcified, prosthesis in mitral position of normal appearance. We conclude that ischemia or myocardial infarction in presence of normal coronaries in patients with bovine pericardial bioprosthesis in aortic position can be secondary to calcium embolism, originated by mineralization process of a degenerated bioprosthesis several years after its implantation.