Key result
Conservative management with anticoagulation may be adequate for aortic valve thrombus in antiphospholipid syndrome, as demonstrated in a 45-year-old woman with an isolated aortic valve mass.
Why the study?
Aortic valve thrombus, a rare complication of antiphospholipid syndrome, is important to distinguish from Libman-Sacks endocarditis because of its responsiveness to anticoagulation.
Case Report (n=1)
Multimodality imaging can help distinguish aortic valve thrombus from Libman-Sacks endocarditis in patients with APLS, potentially sparing them from unnecessary surgery by allowing for conservative management with anticoagulation.
Aortic valve (AV) thrombus, a rare complication of antiphospholipid syndrome (APLS), is important to distinguish from Libman-Sacks endocarditis because of its responsiveness to anticoagulation. This may be attributed to immunopathologic differences underpinning their development. We present the case of a 45-year-old woman with high-risk primary APLS who developed an AV mass and was taken for valvular repair surgery but found to have pure thrombus and normal valve leaflets. In such cases, a trial of conservative management with anticoagulation may be adequate. Echocardiography, computed tomography and MRI findings suggestive of thrombus without endocarditis are presented. A literature review of histopathologic, imaging and treatment implications of pure AV thrombus in the context of APLS is included.
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Premyodhin et al. (2020) conducted a case report in Antiphospholipid syndrome (APLS) with aortic valve thrombus (n=1). Conservative management with anticoagulation was evaluated. Conservative management with anticoagulation may be adequate for aortic valve thrombus in antiphospholipid syndrome, as demonstrated in a 45-year-old woman with an isolated aortic valve mass.
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