Calcified thrombi of the Valsalva sinuses mimicking an aortic valve tumour.
Ryo NakamuraKentaro HondaHideki KunimotoYoshiharu NishimuraPublished in: Interactive cardiovascular and thoracic surgery (2022)
Tumours or tumour-like lesions around the aortic valve are relatively rare and are difficult to diagnose. We report an interesting case of calcified thrombi in the Valsalva sinuses and coronary cusps that mimicked an aortic valve tumour. A 68-year-old man presented with a 20-mm calcified mass in the non-coronary and left-coronary cusps extending to their corresponding Valsalva sinuses, which was detected by echocardiography and contrast-enhanced computed tomography. The lesions were resected to establish the diagnosis and prevent systemic embolization. Intraoperative and histopathological examination revealed an atrophied non-coronary leaflet and calcified atherosclerotic lesions of the Valsalva sinuses and contiguous parts of the cusps, with ulceration and fibrin thrombi. The lesions were resected and aortic valve replacement was performed to avoid aortic valve dysfunction. The patient's atrial fibrillation was controlled, and anticoagulants were discontinued 3 months postoperatively. Surgery to establish the diagnosis and to prevent systemic thromboembolism was thought to be reasonable, even in the absence of valvular dysfunction.
Keyphrases
- aortic valve
- coronary artery
- aortic valve replacement
- aortic stenosis
- computed tomography
- transcatheter aortic valve replacement
- transcatheter aortic valve implantation
- contrast enhanced
- coronary artery disease
- magnetic resonance imaging
- atrial fibrillation
- magnetic resonance
- diffusion weighted
- lymph node
- oxidative stress
- left ventricular
- diffusion weighted imaging
- pulmonary hypertension
- coronary artery bypass
- oral anticoagulants
- mitral valve
- prognostic factors
- surgical site infection
- platelet rich plasma