J Cardiovasc Ultrasound.  2014 Sep;22(3):148-150. 10.4250/jcu.2014.22.3.148.

Native Aortic Valve Thrombosis Resembling Papillary Fibroelastoma

• Kim M
• Kim SH
• Moon SY
• Jeong EG
• Jung EH
• Nam HS
• Choi JH
• Park K

• KMID: 2045432
• DOI: http://doi.org/10.4250/jcu.2014.22.3.148

Abstract

The differential diagnosis of cardiac mass is important in determining the therapeutic plan and avoiding unnecessary surgical intervention. Non-invasive imaging methods would be useful in the diagnosis of suspected cardiac mass, because they may provide earlier diagnosis and more accurate assessment of cardiac mass. Native aortic valve thrombosis is a rare disorder and difficult to differentiate from a tumor, and in particular, a papillary fibroelastoma. Thus, the clinical decision making with imaging modalities should be performed cautiously. We recently met a female patient who had a aortic valve mass resembling papillary fibroelastoma in normal native valve. The patient underwent a surgical resection and the pathologic finding showed an organized thrombus with no evidence of papillary fibroelastoma.

Keyword

Thrombosis; Aortic valve; Pulmonary embolism

MeSH Terms

Aortic Valve*
Decision Making
Diagnosis
Diagnosis, Differential
Female
Humans
Pulmonary Embolism
Thrombosis*

Figure

• 

  Fig. 1 A: Chest computed tomography with contrast showing pulmonary embolism at the bifurcation of the common pulmonary artery and in its main branches (arrow). B: Computed tomography showing a filling defect attached to aortic valve (arrow). C: Short-axis view of transesophageal echocardiogram showing mass filling the non-coronary sinus of Valsalva (arrow). D: Long-axis view of transesophageal echocardiogram showing a mass just behind the non-coronary cusp (arrow). E: Histologic photomicrography of cardiac mass showing organized thrombus (hematoxylin & eosin stain, × 40). F: Follow-up computed tomography after surgical excision showing complete disappearance of the thrombus.

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