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http://dx.doi.org/10.1530/ERP-14-0066DOI Listing

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Transthoracic echocardiography (TTE) is frequently utilized in the initial evaluation of cardioembolic stroke. However, the diagnostic utility of TTE is often operator-dependent, and in conjunction with anatomical limitations, there is a range of sensitivities reported in the literature specifically in the evaluation of nonbacterial thrombotic endocarditis (NBTE). Thus, relying on TTE findings to rule out NBTE in the setting of cardioembolic stroke evaluation can lead to misdiagnosis in the absence of confirmatory transesophageal echocardiography (TEE).

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Non-bacterial thrombotic endocarditis (NBTE) is a rare, often asymptomatic, condition. A 55-year-old woman presented with hemiparesis, facial palsy and chest pain. After urgent investigation, she was referred as a case of type A aortic dissection complicated by tamponade, myocardial infarction and stroke.

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Marantic endocarditis - A not so benign entity.

J Forensic Leg Med

August 2012

Discipline of Anatomy and Pathology, Level 3 Medical School North Building, The University of Adelaide, Frome Rd, Adelaide, SA, 5000, Australia.

Marantic, verrucous or nonbacterial thrombotic endocarditis, is characterised by the deposition of an amorphous mixture of fibrin and platelets onto heart valves. Although not commonly a cause of death in forensic practice, it may be associated with systemic embolisation. This was observed in a 60-year-old woman who suddenly collapsed and was found at autopsy to have a poorly differentiated adenocarcinoma of the lung with vegetations from marantic endocarditis on the mitral valve and embolisation with infarcts in the left kidney, the spleen, the right occipital cortex of the brain and the left ventricle of the heart.

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Cryopreserved aortic allograft tissue is used to correct aortic valve disease in adults and to reconstruct the right ventricular outflow tract in children with congenital heart disease. In adults, allograft durability is regarded as comparable to or better than that of manufactured bioprostheses, with failure usually due to slow fibrocalcific degeneration. Normally, allograft semilunar valves have excellent hemodynamics and low rates of infectious endocarditis and thromboembolism.

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