A woman with a history of stroke and a mass in the aorta

摘要

A 65-YEAR-OLD WOMAN presented with an acute onset of slurred speech and left facial droop. She had a past medical history of Raynaud's disease, well-controlled hypertension, and moderate tricuspid regurgitation, which was being followed by serial transthoracic echocardiographic examinations. A duplex ultrasound of the carotid and vertebral arteries was negative, whereas a magnetic resonance imaging scan of her brain revealed a subacute embolic cerebral infarction. A transesophageal echocardiographic (TEE) examination also was performed during the workup, revealing the presence of moderate-to-severe tricuspid regurgitation and a 1.4 X 1 cm mobile echodensity attached to the aortic wall in close proximity to the sinotubular junction. Intravenous heparin therapy was initiated immediately. Based on her presentation and findings, it was decided to proceed to immediate excision of the aortic mass using cardiopulmonary bypass. What is the diagnosis shown in Figure 1?