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J Thorac Cardiovasc Surg 2006;131:1171-1172
© 2006 The American Association for Thoracic Surgery

Brief Communication

Thromboembolism from the noncoronary cusp of a patient with a normal aortic valve and protein C deficiency

Shunya Shindo, MD * , Kenji Kubota, MD, Masahiko Matsumoto, MD

Second Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan

Received for publication November 25, 2005; accepted for publication December 9, 2005.

* Address for reprints: Shunya Shindo, MD, Second Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Tamaho-cho, Nakakoma-gun, Yamanashi 409-3898, Japan (Email: sshindo@yamanashi.ac.jp).

The first 20% of the full text of this article appears below.

Native aortic valve thrombi, especially when not associated with an abnormal aortic valve or infectious endocarditis, are rare. Here we report a case of acute lower-extremity thromboembolism caused by an aortic valve thrombus that was attached to the noncoronary cusp in the normal aortic valve. The thrombosis was presumably caused by protein C deficiency because preoperative laboratory examinations otherwise showed normal findings. Our review of the literature also suggests that the noncoronary cusp is at higher risk for thrombus formation in the structurally normal aortic valve.

Clinical Summary

A 61-year-old man with a 30-year history of hypertension visited our hospital, complaining of acute right lower extremity pain and coldness. Angiography revealed a right popliteal artery occlusion with embolic characteristics. Laboratory tests, electrocardiography, and transthoracic echocardiography showed normal findings except for a 30% decrease in protein C antigen and a 36% decrease in protein C activity. Thromboembolectomy was performed through the distal popliteal artery. An aortic valve . . . [Full Text of this Article]






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