PMC5358295_01
Transthoracic (A-C) and transesophageal (D) echocardiograms showed severe global LV systolic dysfunction and dilatation with a large mobile pedunculated mass in the LV apex.
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F1
Transthoracic and transesophageal echocardiograms (done at operation room) revealed severe global LV systolic dysfunction (left ventricular ejection fraction [LVEF] of 19%) and dilatation (LV diameter of 65 cm in systole) with ovoid shaped hyperechoic mass-like lesion in LV apex (Fig. 1). A large mobile pedunculated mass measuring 4.3 x 4.2 cm was attached with a narrow stalk to the apical segment and the protruding into the LV cavity (Fig. 1).
Computed tomography angiography and brain magnetic resonance imaging showed obstructions of right femoral and popliteal artery and left popliteal artery (A) and spotty ischemic brain lesions (B).
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F2
Brain magnetic resonance imaging and computed tomography angiography were performed for evaluation of right hemiparesis, coldness and pulseless of both lower limbs and showed spotty ischemic brain lesions and obstructions of right femoral and popliteal artery and left popliteal artery, respectively (Fig. 2 A, B).
The gross examinations of specimen removed from LV apex showed thrombus with multiple fragments of deep reddish blood clot-like material.
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F3
The gross and microscopic examinations of specimen removed from LV apex revealed thrombus with multiple fragments of deep reddish blood clot-like material (Fig. 3).