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Lambl's excrescences: review and recommendations
Faisal Aziz1, Frank A Baciewicz
1Section of Cardio-thoracic Surgery, Wayne State University, Detroit, Michigan 48202, USA. faisalaziz116@yahoo.com
Texas Heart Institute Journal
|October 20, 2007
Summary
Lambl's excrescences, small growths on heart valves, can cause strokes. Surgical removal and monitoring are key for patients experiencing stroke-like symptoms.
Area of Science:
- Cardiology
- Neurology
- Pathology
Background:
- Lambl's excrescences are filiform vegetations on endocardial surfaces at valve closure sites.
- These growths can embolize, leading to potential cerebrovascular events.
Observation:
- A 61-year-old woman presented with recurrent stroke episodes.
- Transesophageal echocardiography revealed Lambl's excrescences on all three aortic valve leaflets.
- Other stroke etiologies were excluded.
Findings:
- Histopathology confirmed Lambl's excrescences.
- The patient experienced no further cerebrovascular embolic events post-aortic valve débridement surgery.
- Transesophageal echocardiography is highly sensitive for detecting these excrescences.
Implications:
- Transesophageal echocardiography should be considered in stroke evaluations.
- Asymptomatic patients require close monitoring.
- Anticoagulation is recommended after one cerebrovascular accident; surgery is advised for a second episode.