Resection of Lambl's Excrescence on the Aortic Valve in a Patient with Rheumatic Mitral Valve Disease and a Left Atrial Thrombus

Authors

  • Jeffrey A. Morgan
  • Gaetano Paone

DOI:

https://doi.org/10.1532/HSF98.20121023

Abstract

Lambl's excrescences (LEs) are filiform strands that form on heart valves and are associated with an increased risk of stroke due to embolization. Although resection of these strands is generally recommended in patients who present with a stroke and no other identifiable cause, the management of incidentally discovered LEs in patients without an adverse cardioembolic event is less clear. We report a case of a patient with severe mitral valve stenosis from rheumatic heart disease and a large left atrial thrombus who was incidentally found to have multiple LEs on her aortic valve. In addition to replacing her mitral valve and removing the left atrial thrombi, we resected the LEs from her aortic valve due to their potential to cause a stroke and the relatively low associated morbidity in resecting them while keeping the aortic valve leaflets and valve function intact.

References

Aziz F, Baciewicz FA Jr. 2007. Lambl's excrescence: review and recommendations. Tex Heart Inst J 34:366-8.nFreedberg RS, Goodkin GM, Perez JL, Tunick PA, Kronzon I. 1995. Valve strands are strongly associated with systemic embolization: a transesophageal echocardiographic study. J Am Coll Cardiol 26:1709-12.nHomma S, Di Tullio MR, Sciacca RR, Sacco RL, Mohr JP; PICSS Investigators. 2004. Effect of aspirin and warfarin therapy in stroke patients with valvular strands. Stroke 35:1436-42.nNakahira J, Sawai T, Katsumata T, Imanaka H, Minami T. 2008. Lambl's excrescence on aortic valve detected by transesophageal echocardiography. Anesth Analg 106:1639-40.nRoldan CA, Shively BK, Crawford MH. 1997. Valve excrescence: prevalence, evolution and risk for cardioembolism. J Am Coll Cardiol 30:1308-14.nVoros S, Nanda NC, Thakur AC, Winokur TS, Samal AK. 1999. Lambl's excrescence (valvular strands). Echocardiography 16:399-414.n

Published

2012-08-23

How to Cite

Morgan, J. A., & Paone, G. (2012). Resection of Lambl’s Excrescence on the Aortic Valve in a Patient with Rheumatic Mitral Valve Disease and a Left Atrial Thrombus. The Heart Surgery Forum, 15(4), E215-E217. https://doi.org/10.1532/HSF98.20121023

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