Multiple Lambl's excrescences with subvalvular extension, a rare cause of cryptogenic stroke: treated by port-access cardiac surgery

A young male patient was evaluated for a cardiac cause of ischaemic stroke. In the work-up, a tumour was detected on the subvalvular apparatus of the mitral valve for which operative removal was scheduled. A port-access procedure was applied as a novel way of treatment. On thoracoscopic intracardiac...

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Bibliographic Details
Published in:BMJ case reports 2013-12, Vol.2013, p.bcr2013201161
Main Authors: Al-Ansari, S, Hindori, V, Riezebos, R K, Yilmaz, A
Format: Article
Language:English
Subjects:
Cardiac Surgical Procedures
Chordae Tendineae - pathology
Diagnosis, Differential
Diagnostic Imaging
Endoscopy
Europe (West)
Heart Neoplasms - complications
Heart Neoplasms - diagnosis
Heart Neoplasms - surgery
Heart surgery
Heart Valve Diseases - complications
Heart Valve Diseases - diagnosis
Heart Valve Diseases - surgery
Heart Valve Prosthesis
Humans
Hypotheses
Male
Mitral Valve - pathology
Rare Disease
Stroke
Stroke - etiology
Thoracoscopy
Tumors
White
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Summary:A young male patient was evaluated for a cardiac cause of ischaemic stroke. In the work-up, a tumour was detected on the subvalvular apparatus of the mitral valve for which operative removal was scheduled. A port-access procedure was applied as a novel way of treatment. On thoracoscopic intracardiac inspection, however, multiple tumours were seen attached to the chordae tendineae and to the anterior leaflet of the mitral valve. It was decided to not to perform a plasty but to remove the valve in toto and insert a mechanical valve prosthesis. The tumours were diagnosed as multiple giant Lambl's excrescences.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-201161