Left main coronary artery embolus: unusual presentation of papillary fibroelastoma of the aortic valve.
The usual cause of left main coronary artery obstruction is atherosclerotic occlusion resulting from plaque rupture and subsequent thrombus formation. In previously reported cases, tumor embolization into the coronary arteries caused sudden death and was detected only at autopsy. Herein, we report an unusual presentation of cardiac papillary fibroelastoma of the aortic valve in a 62-year-old man. The fibroelastoma caused a left main coronary artery embolus and symptoms of acute coronary syndrome. The fibroelastoma was successfully excised during a valve-sparing surgical procedure. We believe that this is the 1st report of tumor embolization to the left main coronary artery--and in a living patient.
Raju
Vijayakumar
V
Department of Cardiothoracic Surgery, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore 641037, India.
Srinivasan
Muralidharan
M
Padmanaban
Chandrasekar
C
Soundararajan
Sarveswaran
S
Kuppanna
Periyasamy J
PJ
D054058:Acute Coronary Syndrome / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001021:Aortic Valve / Q000473:pathology* / Q000601:surgery; D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D004452:Echocardiography; D004617:Embolism / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005350:Fibroma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006338:Heart Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome