Aortic Valve Vegetation Without Endocarditis

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Presentation transcript:

Aortic Valve Vegetation Without Endocarditis Sacha P. Salzberg, MD, Dmitry Nemirovsky, MD, Martin E. Goldman, MD, David H. Adams, MD The Annals of Thoracic Surgery Volume 88, Issue 1, Pages 267-269 (July 2009) DOI: 10.1016/j.athoracsur.2008.10.006 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Transesophageal echocardiogram shows two serpiginous, multilobar lesions (1, 2) on the left ventricular surface of the left and noncoronary cusps of the aortic valve. The lesions measured 4 cm and 2 cm, respectively. They prolapsed into the left ventricular outflow tract during diastole and into the aorta during systole. There was minimal associated aortic regurgitation. The Annals of Thoracic Surgery 2009 88, 267-269DOI: (10.1016/j.athoracsur.2008.10.006) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Computed tomography scan of the brain shows a large area of acute infarction with associated ischemic edema that is centered in the right basal ganglia region in the distribution of the lenticulostriate branches of the right middle cerebral artery. The infarct may have some mild hemorrhagic component. The Annals of Thoracic Surgery 2009 88, 267-269DOI: (10.1016/j.athoracsur.2008.10.006) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Follow-up transesophageal echocardiogram performed 3 weeks later shows a marked decrease in the size of the lesions (dotted lines) while the patient was taking warfarin. The Annals of Thoracic Surgery 2009 88, 267-269DOI: (10.1016/j.athoracsur.2008.10.006) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Follow-up transesophageal echocardiogram performed 4 months after original shows nearly complete resolution of the valvular lesions. The aortic valve remained competent. The Annals of Thoracic Surgery 2009 88, 267-269DOI: (10.1016/j.athoracsur.2008.10.006) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions