A 64-year-old man presented to our hospital with visual loss on the left eye due to central retinal artery occlusion diagnosed by another ophthalmological hospital. Magnetic resonance imaging revealed small multiple cerebral infarctions on bilateral hemisphere. Transesophageal echocardiography was performed, which revealed a mass lesion like a tumor with calcification on the mitral valve. We suspected that a mass lesion is calcified amorphous tumor (CAT). Surgical resection of the mass lesion was performed, and it was diagnosed CAT by pathological examination. CAT is considered as high risk of cerebral embolism, surgical treatment should be considered as early as possible.
A 71-year-old woman was admitted to our hospital with an acute Stanford type A aortic dissection. She underwent tricuspid valve plasty and ascending aorta repair. On day 7 she presented with aphasia. Brain computed tomography (CT) revealed a low-density area in the left frontal lobe. Carotid Doppler ultrasonography disclosed that the left common carotid artery was occluded up to a point just proximal to the carotid bifurcation, and retrograde flow was seen from the external carotid artery (ECA) to the internal carotid artery via the carotid bifurcation. These findings suggested a collateral anastomosis between the ECA and the vertebral artery. Four-dimensional CT angiography is sufficiently effective for evaluation of occipital-vertebral anastomosis.
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