Calcified thrombi of the Valsalva sinuses mimicking an aortic valve tumour. (2nd September 2022)

• Record Type: Journal Article
• Authors: Nakamura, Ryo; Honda, Kentaro; Kunimoto, Hideki; Nishimura, Yoshiharu
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 35:Number 4(2022)
• Publication Date: 2022-09-02
• Subjects: Calcified thrombi -- Aortic valve tumour -- Tumour-like lesion -- Atherosclerosis; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivac232
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: 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. Abstract : A 68-year-old man with paroxysmal atrial fibrillation and prostatic cancer was diagnosed with an aortic valve tumour by a primary physician, based on echocardiography.