Lambl's excrescences in transcatheter aortic valve implantation: a word of caution on the way to tailored and individualized approach

Saade, Wael; Marullo, Antonino G. M.; Peruzzi, Mariangela

doi:10.23736/s2724-5683.21.05563-8

Cited by 1 publication

(4 citation statements)

References 15 publications

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…8,12 No increased risk of stroke/TIA was noticed in 28 patients with LE and aortic valve stenosis when compared to 48 patients with aortic valve stenosis without LE undergoing transcatheter aortic valve implantation (TAVI). 22 However, the presence of LE along with a single embolic risk factor such as native valve calcification implements the use of cerebral protection devices due to a high embolic risk. 22 Cerebrovascular accidents (CVA) should be investigated thoroughly using carotid duplex ultrasonography, TEE, and hypercoagulability testing to determine the underlying cause, as detecting, and managing LE prevents recurrent attacks, lifethreatening complications, and reduces morbidity.…”

Section: Resultsmentioning

confidence: 99%

“…22 However, the presence of LE along with a single embolic risk factor such as native valve calcification implements the use of cerebral protection devices due to a high embolic risk. 22 Cerebrovascular accidents (CVA) should be investigated thoroughly using carotid duplex ultrasonography, TEE, and hypercoagulability testing to determine the underlying cause, as detecting, and managing LE prevents recurrent attacks, lifethreatening complications, and reduces morbidity. 6,15 LE should be considered in cryptogenic strokes and TEE should be performed even with a normal TTE findings.…”

Section: Resultsmentioning

confidence: 99%

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Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature Review

Alajjuri,

Alani

2023

Clin Med Insights Case Rep

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Lambl’s excrescence (LE), a rare thin linear fibrous thread of collagen and elastic fibrous tissue originating at closure margins of heart valve leaflets is considered a rare cause of thromboembolism, causing ischemic stroke, transient ischemic attack (TIA), acute coronary syndrome, or peripheral thromboembolism. The gold standard for diagnosing LE is transesophageal echocardiography (TEE). Due to the rarity of the disease and lack of significant research, no guidelines exist about the management of LE. Twenty-two papers about LE were reviewed, focusing on the management aspect aiming to assist in guideline publication. Articles were retrieved using PubMed database using “Lambl’s excrescences” as a keyword. All free full text papers up to 2023 were retrieved. In this report, we present the first publication of a case of a TIA secondary to LE in the United Arab Emirates. A 53-year-old male presented with transient attacks of left monocular blindness with complete recovery 2 days later. Extensive stroke work-up was negative, except for TEE, which showed an echo-dense linear mobile structure attached to the aortic surface of the aortic valve closure margin, suggesting LE. As no guidelines exist on the management of LE, the patient was started on Clopidogrel 75 mg daily and remained asymptomatic for 2 years. After reviewing the literature, we suggest the use of Aspirin for patients with ⩾1 embolic event attributed to LE while not on antiplatelets or anticoagulants, as it is the most used and recommended treatment option and is effective in preventing recurrent thromboembolic events.

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