Background: A 75-year-old male with a history of myocardial infarction and recent transient ischemic attack was referred to a cardiology clinic for preoperative evaluation before a cystectomy. Transthoracic and transesophageal echocardiography revealed a mobile mass on the right coronary cusp of the aortic valve. Multislice CT demonstrated a significant narrowing in the proximal left anterior descending coronary artery. Investigations: Physical examination, chest radiography, laboratory testing, electrocardiography, transthoracic and transesophageal echocardiography, multislice-CT coronary angiography, pathological and histological examination of the surgically excised tissue. Diagnosis: Papillary fibroelastoma of the aortic valve in conjunction with coronary artery disease. Management: Surgical excision of the mobile lesion and an end-to-side anastomosis of the left internal mammary artery to the left anterior descending coronary artery.

doi.org/10.1038/ncpcardio1212, hdl.handle.net/1765/30497
Nature Clinical Practice Cardiovascular Medicine
Erasmus MC: University Medical Center Rotterdam

de Visser, R., van Mieghem, C., van Pelt, N., Weustink, A., Kerker, J., & Galema, T. (2008). Papillary fibroelastoma of the aortic valve and coronary artery disease visualized by 64-slice CT. Nature Clinical Practice Cardiovascular Medicine, 5(6), 350–353. doi:10.1038/ncpcardio1212