CTICasesAortic Valve Thrombus
Imaging findings
Cardiac CT and echocardiogram in an asymptomatic patient on chronic anticoagulation for atrial fibrillation demonstrate a large, lobulated, linear soft-tissue mass arising from the aortic valve leaflet adjacent to the non-coronary sinus. Cine loops show the mass prolapsing dynamically back and forth across the aortic valve plane into the ascending aorta. Resection specimen confirms a large, organized thrombus adherent to the non-coronary leaflet, without signs of endocarditis or fibroelastoma.
Key takeaways
Aortic valve thrombus is a rare but potentially catastrophic source of systemic thromboembolism, carrying a high risk of stroke or myocardial infarction. While most cardiac valvular masses represent papillary fibroelastomas, vegetations, or fibroelastomas, thrombi can occasionally form, even in patients undergoing anticoagulation therapy. Surgical resection is indicated to prevent embolic complications.
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