Total occlusion of the left femoral artery by a calcium embolus from a heavily calcified aortic valve. An unusual complication of left heart catheterization treated by embolectomy

Calcified bicuspid aortic valve mass prolapsing into the left main coronary artery

We report a case of a mobile calcific mass on the aortic valve that prolapsed into the left main coronary artery of a 51-year-old man. This case and a review of the literature suggest that calcific embolization to coronary arteries is a rare but possibly underrecognized complication of calcified degenerative or bicuspid aortic valves. This potentially catastrophic complication of calcified aortic valves needs to be suspected and recognized in clinical practice.

Retinal artery embolization: a rare presentation of calcific aortic stenosis

Retinal artery embolization is an unusual but serious complication of calcific aortic stenosis. However, it is rare for retinal embolization to be the presenting feature of aortic stenosis. This report describes a young patient who presented with an acute retinal artery occlusion secondary to calcific aortic valve disease, and discusses the rationale for early surgical intervention.

Spontaneous coronary artery embolus associated with calcific aortic stenosis

Calcific embolization from aortic stenosis may be more frequent than commonly appreciated. Most calcific emboli are clinically silent, although transient ischemic attacks, cerebral infarcts, blindness (from central retinal artery occlusions), and myocardial infarctions have been reported. We describe a patient with calcific bicuspid aortic stenosis who presented with transient ischemic attacks and angina secondary to a calcific embolus to the second circumflex marginal coronary artery. The calcific embolus was retrieved during aortic valve replacement surgery. A review of the literature suggests that calcific embolization from calcific aortic stenosis may occur more commonly in patients with bicuspid valves.

Spontaneous calcific cerebral embolus from a calcific aortic stenosis in a middle cerebral artery infarct

Calcific emboli from a calcific aortic stenosis is an uncommon event, usually following local trauma, as from cardiac surgery or left heart catheterization or as a sequel to bacterial endocarditis. We report what we believe to be the first case of a spontaneous calcareous emboli demonstrated by cranial computed tomography. In this patient, systemic hypertension and mild aortic insufficiency may have caused increasing mechanical forces acting on the aortic cusps and may have precipitated embolism.

Calcific cerebral emboli and aortic stenosis: detection of computed tomography

Embolism with brain infarction rarely complicates calcific aortic stenosis (CAS). We report a case with severe CAS where the patient experienced multiple embolic strokes immediately following retrograde heart catheterization. Calcific emboli in the cerebral arteries were demonstrated by computed tomography (CT).

Calcium emboli to the retinal artery in calcific aortic stenosis

It is generally appreciated in the cardiovascular literature that calcium emboli to a central retinal artery or its branches may be the presenting feature of otherwise uncomplicated calcific aortic stenosis. The ophthalmologic literature provides good evidence for this point. Over a 7-month period, four such cases have come to our attention. Other potential sources of emboli were excluded by standard noninvasive and invasive diagnostic techniques, and two patients underwent successful aortic valve replacement. Previous studies of calcific aortic stenosis have demonstrated postmortem histologic evidence of calcium emboli to various organs, for example, heart, kidney, or brain. Since these emboli are small, their occurrence is clinically silent. The retinal circulation is unique in that its occlusion by a calcium microembolus results in loss of vision, and this symptom may be a clue to the presence of calcific aortic stenosis.