PMC9146607_01
PMC9146607_02
an electrocardiogram shows an ST segment elevation in the anterior leads
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F1
Despite the patient s stable clinical condition, the electrocardiogram showed a transient ST segment elevation in the anterior leads (Figure 1).
a coronarography realized shows no lesions
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F2
Diagnostic assessment: an urgent coronarography was performed in the catheter laboratory, which was normal (Figure 2).
transoesophageal echocardiography short axis view, arrow points to a 10mm /8mm tumour, attached to the non/left commissure
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F3
In the echocardiogram, the cardiologist suspects active endocarditis of the aortic valve, we complete with a transoesophageal echocardiogram which reveals the existence of a pedunculated rounded structure attached to the aortic valve, no aortic stenosis or regurgitation, and moderate left ventricle dysfunction (Figure 3).
computed tomography angiography shows a 0.62/0.88 cm mass attached to aortic leaflet, near the ostium of the main left coronary artery (A, B)
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F4
A computed tomography angiography shows a 8.8mm/6.2mm bell-stick mass, attached to the non/left commissure of the aortic valve (Figure 4).
intraoperative view, arrow points to the mass in the left/ non commissure of the aortic valve
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F5
The coronary ostia were normal (Figure 5, Figure 6A).
macroscopic aspect of the excised mass (A) and histological section of the excised mass, papillae bordered by regular endothelial cells resting on a hyalinized connective axis consistent with papillary fibroelastoma (HE, G x100) (B)
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F6
The coronary ostia were normal (Figure 5, Figure 6A). Histopathologic results were consistent with papillary fibroelastoma of the aortic valve, without signs of malignancy (Figure 6B).