title: Stroke and cardiac papillary fibroelastoma: mechanical thrombectomy after thrombolytic therapy.
abstract: We describe a case of a 34-year-old man with a sudden development of right hemiparesis and aphasia because of infarction of the left middle cerebral artery that was submitted to intravenous (IV) recombinant tissue plasminogen activator and mechanical thrombectomy. Transesophageal echocardiogram showed a small mass on the anterior leaflet of the mitral valve. Cardiac surgery was performed, and histological examination of the removed material was consistent with cardiac papillary fibroelastoma (CPF). Experience in using IV thrombolysis for the treatment of embolic stroke because of CPF is limited. To the best of our knowledge, only 3 patients are reported in literature in whom acute ischemic stroke and associated CPF were treated with thrombolytic therapy. A discussion of the efficacy of IV thrombolysis and the possible superiority of mechanical thrombectomy is included.
authors.affiliation: Department of Neurology, Hospital de Braga, Braga, Portugal. Electronic address: filipasantos@hotmail.com.
authors.forename: Ana F
authors.initials: AF
authors.lastname: Santos
authors.affiliation: Department of Neurology, Hospital de Braga, Braga, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Pinho
authors.affiliation: Department Cardiology, Hospital de Braga, Braga, Portugal.
authors.forename: Vítor
authors.initials: V
authors.lastname: Ramos
authors.affiliation: Department of Pathological Anatomy, Hospital de São João, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Pardal
authors.affiliation: Department of Neuroradiology, Hospital de Braga, Braga, Portugal.
authors.forename: Jaime
authors.initials: J
authors.lastname: Rocha
authors.affiliation: Department of Neurology, Hospital de Braga, Braga, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D002533:Cerebral Angiography / Q000379:methods; D017548:Echocardiography, Transesophageal; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005350:Fibroma / Q000150:complications* / Q000175:diagnosis; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D007262:Infusions, Intravenous; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; C067262:PLAT protein, human; D010959:Tissue Plasminogen Activator
keywords: Cardiac papillary fibroelastoma; mechanical thrombectomy; stroke; thrombolytic therapy