ABSTRACT
BACKGROUND: A 75-year-old male with a history of myocardial infarction and recent transient ischemic attack was referred to a cardiology clinic for preoperative evaluation before a cystectomy. Transthoracic and transesophageal echocardiography revealed a mobile mass on the right coronary cusp of the aortic valve. Multislice CT demonstrated a significant narrowing in the proximal left anterior descending coronary artery. INVESTIGATIONS: Physical examination, chest radiography, laboratory testing, electrocardiography, transthoracic and transesophageal echocardiography, multislice-CT coronary angiography, pathological and histological examination of the surgically excised tissue. DIAGNOSIS: Papillary fibroelastoma of the aortic valve in conjunction with coronary artery disease. MANAGEMENT: Surgical excision of the mobile lesion and an end-to-side anastomosis of the left internal mammary artery to the left anterior descending coronary artery.
