Papillary fibroelastoma of the aortic valve and coronary artery disease visualized by 64-slice CT.

BACKGROUND

A 75-year-old male with a history of myocardial infarction and recent transient ischemic attack was referred to a cardiology clinic for preoperative evaluation before a cystectomy. Transthoracic and transesophageal echocardiography revealed a mobile mass on the right coronary cusp of the aortic valve. Multislice CT demonstrated a significant narrowing in the proximal left anterior descending coronary artery.

INVESTIGATIONS: Physical examination, chest radiography, laboratory testing, electrocardiography, transthoracic and transesophageal echocardiography, multislice-CT coronary angiography, pathological and histological examination of the surgically excised tissue.

DIAGNOSIS: Papillary fibroelastoma of the aortic valve in conjunction with coronary artery disease.

MANAGEMENT: Surgical excision of the mobile lesion and an end-to-side anastomosis of the left internal mammary artery to the left anterior descending coronary artery.