Cluster Lambl's Excrescence on the Aortic Valve: A Case Report and Literature Review

Abstract

Background: Lambl's excrescence (LE) presents challenges due to its small size and elusive nature. Methods: We present a case of an asymptomatic LE patient in which the patient recovered well and a literature review of LE involving the aortic valve (AV). Results: Transthoracic echocardiography revealed 10 × 4 mm strips of highly echoic attachment on the AV, swinging on the aortic side with high motion. The pathological analysis confirmed LE. The patient underwent surgical management, and the excrescence was successfully removed without damaging the AV. No complications were reported during the 18-month follow-up period. Of the 53 patients with LE (including the one in our report) aged 8–80, 18 were female, and 35 were male. The lengths of the LEs ranged from 1 to 32 mm. There were 6 asymptomatic cases, 25 ischemic stroke cases, 1 myocardial infarction case, 15 cases underwent surgical treatment, and 8 cases underwent simple surgical excision of the LE. The commonly used anticoagulants included warfarin, aspirin, clopidogrel, and rivaroxaban. The 27 patients were followed up with good results. Conclusion: For smaller LE, anticoagulants should be taken for a long time and monitored closely. We recommend surgical resection for large LE (longer than 2 cm), patients who have had more than one stroke, or those undergoing other simultaneous intracardiac operations.