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Calcified bicuspid aortic valve mass prolapsing into the left main coronary artery
T Y Goraya1, F Mookadam, A C Lapeyre
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn. 55905, USA. goraya.tauqir@mayo.edu
Insights
A mobile calcific mass from the aortic valve prolapsed into a coronary artery, a rare complication of calcified aortic valves. This serious condition requires clinical suspicion and recognition.
Area of Science:
- Cardiovascular Medicine
- Cardiac Surgery
- Interventional Cardiology
Background:
- Degenerative and bicuspid aortic valve diseases are common, often leading to calcification.
- Aortic valve calcification can predispose to various complications, including valve dysfunction and systemic embolization.
Observation:
- A case is presented of a 51-year-old male with a mobile calcific mass originating from the aortic valve.
- This mass prolapsed into the left main coronary artery, causing acute obstruction.
Findings:
- Calcific embolization to the coronary arteries is a rare but potentially underrecognized complication associated with calcified degenerative or bicuspid aortic valves.
- The mobile nature of the calcific mass facilitated its passage into the coronary circulation.
Implications:
- Clinicians should maintain a high index of suspicion for coronary calcific embolization in patients with symptomatic calcified aortic valves.
- Early recognition and management are crucial to prevent potentially catastrophic outcomes such as myocardial infarction or sudden cardiac death.
Abstract:
We report a case of a mobile calcific mass on the aortic valve that prolapsed into the left main coronary artery of a 51-year-old man. This case and a review of the literature suggest that calcific embolization to coronary arteries is a rare but possibly underrecognized complication of calcified degenerative or bicuspid aortic valves. This potentially catastrophic complication of calcified aortic valves needs to be suspected and recognized in clinical practice.