A 49-year-old woman with a history of hypertension, diabetes mellitus and aortic valve replacement five years ago, admitted to our outpatient clinic with shortness of breath. Transesophageal echocardiography revealed a 5x2 mm thrombus on the anterior face of prosthetic aortic valve. A throm-bolytic therapy (TT) was initiated but it was unsuccessful. In the tenth day of follow-up, she experienced chest pain with ST segment elevations through V2-V6 derivations on her ECG. With the diagnosis of acute myocardial infarction, the patient was taken into the catheterization laboratory. In the coronary angiography, the mid segment of left anterior descending artery was completely occluded by a thrombus. Percutaneous transluminal coronary angioplasty was performed but it was failed. After then TT was started again. The second TT has become successful both in terms of coronary revascularization and resolusion of valve thrombosis.