Marantic Valvular Vegetations

Abstract

Marantic valvular vegetations represent one form of vegetative nonbacterial endocarditis. While any of the cardiac valves may be involved, the mitral valve and/or aortic valve are the most common sites at which this process occurs. Underlying disease of a chronic nature is usually identifiable somewhere in the body, with malignant tumors collectively representing the most common underlying condition. Systemic arterial occlusion, usually multiple when present, may antedate the identification of an underlying malignant tumor.The gross nature of the vegetations requires histologic distinction from metastatic lesions of valves and from bacterial endocarditis. In some instances, the latter process may originate upon marantic vegetations.

Development of Non-bacterial Thrombotic Endocarditis after Percutaneous Transvenous Mitral Commissurotomy for Severely Calcified Mitral Stenosis.

“…We have reported a case of non-bacterial thrombotic endocarditis (NBTE) [4][5][6][7][8][9][10] occurring as a rare complication of PTMC despite adequate anticoagulation therapy. The protrusion recognized in this case appeared to be an organized thrombus, based on its echocardiographic and microscopic features.…”

“…2,3) Furthermore, an indication of PTMC has been extended to include even relatively complicated cases. To date, there have been no reports of the occurrence of non-bacterial thrombotic endocarditis (NBTE) [4][5][6][7][8][9][10] at the dilated site after this procedure. We report a case of thrombus formation that occurred insidiously as a rare complication of PTMC.…”

“…However, it is most commonly observed in patients with malignant neoplasms, 9,14) particularly adenocarcinoma, or disseminated intravascular coagulation. 14,15) On the other hand, NBTE also develops in patients with chronic rheumatic valvulitis 10) , or non-specific abnormalities such as fibrous thickening or fibrous and hyaline nodularitis of heart valves.…”

Nonbacterial Thrombotic Endocarditis and Nondisseminated Malignancy Associated with Osteopetrosis

“…Marantic vegetations are microscopically composed of platelets and fibrin and are found most commonly on the mitral and/or aortic valves, but can be found on any valve [25], These vegetations lead to emboli in up to 90% of cases.…”

Recurrent cerebral infarcts secondary to marantic endocarditis in a patient with adenocarcinoma of the lung

“…(2) In a previous study, 18% of patients with cerebral infarcts and malignancy had marantic endocarditis on TOE. (4) The presence of vegetation on the coaptation surface, normal valvular tissue and negative blood cultures are strongly indicative of marantic endocarditis. (5) Vegetation in marantic endocarditis appears small, irregular and has a broad base.…”