title: Left main coronary artery embolus: unusual presentation of papillary fibroelastoma of the aortic valve.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore 641037, India.
authors.forename: Vijayakumar
authors.initials: V
authors.lastname: Raju
authors.forename: Muralidharan
authors.initials: M
authors.lastname: Srinivasan
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Padmanaban
authors.forename: Sarveswaran
authors.initials: S
authors.lastname: Soundararajan
authors.forename: Periyasamy J
authors.initials: PJ
authors.lastname: Kuppanna
mesh_terms: 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