Cor Vasa 2014, 56(5):e413-e416 | DOI: 10.1016/j.crvasa.2013.09.005

Native aortic valve thrombus as a source of embolisation into the coronary artery

Kamil Novobílský^a,*, Vladimír Kaučák^a, Jiří Bárta^b, Radim Kryza^a, Jana Dvořáčková^c

^a Kardiologie, Městská nemocnice Ostrava, Ostrava, Česká republika

^b Kardiochirurgické centrum, Fakultní nemocnice Ostrava, Ostrava, Česká republika

^c Ústav patologie, Fakultní nemocnice Ostrava, Ostrava, Česká republika

Authors present the case of 66-year-old patient after repeated systemic embolisations (lower extremity, axillary artery), admitted for inferior myocardial infarction. Coronary angiography demonstrated peripheral subtotal occlusion of posterior descending artery (PDA) of embolic origin. Transoesophageal echocardiography (TOE) revealed mobile mass on aortic valve, which was subsequently extirpated surgically. Histological examination described thrombus. Case report depicts the native aortic valve thrombus as a rare source of systemic or coronary embolisation. It simultaneously supports the indication of TOE at systemic embolisations of unknown source, even if transthoracic echocardiography (TTE) finding is normal, and shows its key role in diagnostic algorithm in similar events.

Keywords: Aortic valve; Myocardial infarction; Systemic embolisation; Thrombus; Transoesophageal echocardiography

Received: August 29, 2013; Accepted: September 27, 2013; Published: October 1, 2014  Show citation