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Recurrent ischemic strokes in a patient with Medtronic-Hall prosthetic aortic valve and valve strands

K Hutchinson1, F Hafeez, T D Woods

  • 1University of Wisconsin Hospital and Clinics, Department of Medicine, Madison 53792-3248, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|August 6, 1998
PubMed

Insights

Fine strands on prosthetic heart valves are often seen but not identified. In a patient with a Medtronic-Hall valve and strokes, these strands were confirmed as Lambl's excrescences.

Area of Science:

  • Cardiovascular Pathology
  • Prosthetic Heart Valve Research
  • Neurology

Background:

  • Transesophageal echocardiography (TEE) can visualize fine strands on prosthetic heart valves.
  • The exact nature and clinical significance of these visualized strands remain incompletely understood.

Observation:

  • A patient presented with a Medtronic-Hall prosthetic aortic valve exhibiting prominent valve strands.
  • This patient experienced recurrent episodes of stroke, raising concern for a potential link to the valve findings.

Findings:

  • Histopathologic examination of the excised valve strands definitively identified them as Lambl's excrescences.
  • Lambl's excrescences are typically associated with native heart valves but were confirmed in this prosthetic valve case.

Implications:

  • This case clarifies the pathologic identity of echocardiographic strands seen on prosthetic valves.
  • Understanding Lambl's excrescences on prosthetic valves may improve stroke risk assessment and management in affected patients.

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