Anesthetic Experience of Patient with Lambl's Excrescences

Authors

  • Nam Yung Kim Department of Anesthesiology and Pain Medicine, Institute of Medical Sciences, Kangwon National University Hospital, School of Medicine, Chuncheon, South Korea
  • Seongsik Kang Department of Anesthesiology and Pain Medicine, Institute of Medical Sciences, Kangwon National University Hospital, School of Medicine, Chuncheon, South Korea
  • Se Jin Kim Department of Anesthesiology and Pain Medicine, Institute of Medical Sciences, Kangwon National University Hospital, School of Medicine, Chuncheon, South Korea
  • So Yeon Cho Department of Anesthesiology and Pain Medicine, Institute of Medical Sciences, Kangwon National University Hospital, School of Medicine, Chuncheon, South Korea

DOI:

https://doi.org/10.24203/ajpnms.v8i2.6102

Keywords:

embolism, stroke, echocardiography

Abstract

Lambl’s excrescences(LE) are mobile, thin, filiform structures that occur at sites of valve closure. LE are mostly asymptomatic but atheroma from LE may embolize to cerebrovascular arterial territory causing stroke. A 79 year old man with mechanical ileus of small bowel loop and pelvic mass scheduled for palliative enteroenterostomy. His transthoracic echocardiography showed a filiform hyperechoic mass attached to the tip of noncoronary cusp, suggestive of LE. To prevent cardioembolic stroke during perioperative period, we tried to prevent blood pressure fluctuation during surgery. Also we monitored regional cerebral oxygen saturation by cerebral/somatic  oximeter for early detection of cerebral ischemia. A patient had no neurological changes and signs of cerebral infarction after surgery.

References

Lambl VA. Papillare excrescenzen und der semilunar-klappe der aorta. Wien Med Wochenschr.

; 16 :244–247.

Aziz F, Baciewicz FA. Lambl’s excrescences: review and recommendations. Tex Heart Inst J, 2007;

: 366–68

Voros S, Nanda NC, Thakur AC et al: Lambl’s excrescences (valvular strands). Echocardiography, 1999; 16: 399–414

Amstrong W, Ryan T. Feigenbaum’s Echocardiography 7th ed. Lippincott Williams & Wilkins.

; 11: 293

Chu A, Aung TT, Sahalon H, Choksi V, Feiz H. Lambl's Excrescence Associated with Cryptogenic Stroke: A Case Report and Literature Review. Am J Case Rep. 2015; 16:876–881.

Kamran H, Patel N, Singh G, Pasricha V, Salifu M, et al. (2016) Lambl's excrescences: A case report and review of the literature. Clinical case reports and reviews 2: 486.

Davogustto G, Fernando RR, Loghin C (2015) Lambl's excrescence, migrainous headaches, and “tiger stripesâ€: puzzling findings in one patient. Tex Heart Inst J 42: 70–72.

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Published

2020-04-21

How to Cite

Kim, N. Y., Kang, S., Kim, S. J., & Cho, S. Y. (2020). Anesthetic Experience of Patient with Lambl’s Excrescences. Asian Journal of Pharmacy, Nursing and Medical Sciences, 8(2). https://doi.org/10.24203/ajpnms.v8i2.6102

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Articles