Key result
A valvular strand on the aortic valve was identified by transesophageal echocardiography in a 47-year-old woman suffering an acute embolic stroke.
Case Report (n=1)
This case report highlights the association between valvular strands (such as giant Lambl's excrescences) and embolic stroke, noting that standard management recommendations remain unclear.
Alerts clinicians to valvular strands in cryptogenic stroke; leaves open optimal management pending prospective data.
We report the case of a previously healthy 47-year-old woman suffering an acute embolic stroke in the left middle cerebral artery distribution. A filiform structure along the line of the aortic valve was first identified by transesophageal echocardiography, leading to the diagnosis of a valvular strand. These masses are thought to represent giant Lambl's excrescences, although differential diagnoses include several benign cardiac tumors, e.g. papillary fibroelastoma. Valvular strands have previously been associated with embolic events including stroke, although exact pathogenetic mechanisms and further patient management have not yet been fully established. This case report additionally provides a short overview of the currently existing literature. As a conclusion, standard recommendations for patient management and treatment cannot be derived from currently available evidence.
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Wolf et al. (2007) conducted a case report in Acute embolic stroke and valvular strand (n=1). Valvular strand was evaluated. A valvular strand on the aortic valve was identified by transesophageal echocardiography in a 47-year-old woman suffering an acute embolic stroke.
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