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CC BY 4.0 · Aorta (Stamford) 2015; 03(05): 172-176
DOI: 10.12945/j.aorta.2015.15.010
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Deep Crater in Heavily Calcified Aortic Valve Leaflet

A “Smoking Gun” for Embolic Stroke
Sarah Chaoying Xu
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut, USA
,
Lisa Canter
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut, USA
,
Ahmad Zeeshan
2   Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA
,
John A. Elefteriades
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut, USA
› Author Affiliations
Further Information

Publication History

25 March 2015

26 May 2015

Publication Date:
24 September 2018 (online)

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Abstract

The association of severe calcific aortic stenosis with clinically significant stroke has not been well established. This case vividly describes the relationship with clinical and pathological (gross and microscopic) findings in a 62-year-old man with a severely calcified bicuspid aortic valve. Eleven months prior to aortic valve surgery, the patient had stigmata of cerebral embolic events in the absence of any other embolic source. During the aortic valve replacement surgery for aortic stenosis, he was found to have a large atheroma on the aortic valve cusp with a crater containing friable debris in its center. These findings support the potential for embolic stroke in patients with severe calcific aortic stenosis. We recommend that the aortic valve be considered as an embolic source in patients with an otherwise cryptogenic cerebrovascular accident.

Key Words

Calcified aortic valve - Cerebrovascular events - Bicuspid aortic valve - Aortic valve replacement
 

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