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A vegetation on the surface of left ventricular muscle and subvalvular tissue just below the anterolateral commissure of the mitral valve without exposure to regurgitation or shunt jet
  • +3
  • kenji masada,
  • Hironori Ueda,
  • Masamichi Ozawa,
  • Norimasa Mitsui,
  • hiroto utsunomiya,
  • Shinya Takahashi
kenji masada

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Hironori Ueda
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Masamichi Ozawa
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Norimasa Mitsui
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hiroto utsunomiya
Cedars-Sinai Heart Institute
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Shinya Takahashi
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Abstract

Bacteria can adhere to cardiac endothelium damaged by regurgitation or shunt jet; however, healthy cardiac endothelium is supposedly resistant to bacterial adhesion. Bacterial vegetations are most common on cardiac valves, but are rarely observed at other sites. We report a case of a vegetation on the surface of left ventricular muscle/subvalvular tissue without regurgitation or shunt jet. Transthoracic echocardiography did not detect the vegetation because of its unique location; however, transesophageal echocardiography (TEE) did detect. In conclusion, vegetations can form without exposure to regurgitation or shunt jet, and TEE is highly sensitive for detecting the vegetation in unusual locations.