Late Embolization of a Cor-Knot Fastener Device Resulting in Left Anterior Descending Artery Occlusion

A 57-year-old female patient underwent elective minimally invasive mitral valve repair surgery. Automatic suture fasteners were used for annuloplasty ring implantation. Six months after surgery, the patient presented with new onset exertional dyspnoea, fatigue, and thoracic pain. In transthoracic echocardiography, new regional wall motion abnormalities of the left ventricular apex were seen. A heart catheterization was performed, identifying 2 metallic foreign bodies in the left anterior descending artery, causing an occlusion of the vessel. Cardiac imaging revealed a transmural scar in the apical segments. Through this case, we aim to highlight an extremely rare late complication after mitral valve repair surgery.