The association of severe aortic stenosis and narrow aortic root in a young patient — What is the etiology: Rheumatic valvulitis or Lambl's excrescences?

Abstract

Aortic valve stenosis is the most common cause of left ventricular outflow obstruction in children and adults. There are several etiologies that lead to aortic stenosis like rheumatic, congenital and degenerative. Lambl's excrescences are congenital anomalies that usually occur at the sites of valve closure. They originate as small thrombi on endocardial surfaces and carry a risk for potential sources of embolism to distal organs [ 1 Aziz F. Baciewicz Jr., F.A. Lambl's excrescences: review and recommendations. Tex. Heart Inst. J. 2007; 34 (Review): 366-368 PubMed Google Scholar , 2 Jaffe W. Figueredo V.M. An example of Lambl's excrescences by transesophageal echocardiogram: a commonly misinterpreted lesion. Echocardiography. 2007 Nov; 24: 1086-1089 Crossref PubMed Scopus (21) Google Scholar , 3 Dumaswala B. Dumaswala K. Hsiung M.C. Quiroz L.D. Sungur A. Escanuela M.G. et al. Incremental value of three-dimensional transesophageal echocardiography over two-dimensional transesophageal echocardiography in the assessment of Lambl's excrescences and nodules of Arantius on the aortic valve. Echocardiography. 2013 Sep; 30: 967-975 Crossref PubMed Scopus (7) Google Scholar ].