Anesthetic Experience of Patient with Lambl’s Excrescences

Lambl’s excrescences(LE) are mobile, thin, filiform structures that occur at sites of valve closure. LE are mostly asymptomatic but atheroma from LE may embolize to cerebrovascular arterial territory causing stroke. A 79 year old man with mechanical ileus of small bowel loop and pelvic mass scheduled for palliative enteroenterostomy. His transthoracic echocardiography showed a filiform hyperechoic mass attached to the tip of noncoronary cusp, suggestive of LE. To prevent cardioembolic stroke during perioperative period, we tried to prevent blood pressure fluctuation during surgery. Also we monitored regional cerebral oxygen saturation by cerebral/somatic？ oximeter for early detection of cerebral ischemia. A patient had no neurological changes and signs of cerebral infarction after surgery