Lambl's excrescences (valvular strands)

We review the literature on. Lambl's excrescences (valvular strands). With the widespread use of cardiac imaging modalities, most importantly, with tr ansesophageal echocardiography, abnormal valvular structures are frequently identified on both native and prosthetic heart valves. However, there is n o consensus in the literature on the correct terminology of these structure s. The relationship between valvular strands (the so-called Lambl's excresc ences) and papillary fibroelastomas has not been well established. In this review, we attempt to summarize the available echocardiographic descriptors and the gross macroscopic and histological features of Lambl's excrescence s (valvular strands). In addition, we review the etiology, pathogenesis, an d clinical implications of these cardiac excrescences. Also, we describe fe atures that help to distinguish between. Lambl's excrescences and papillary fibroelastomas. Because valvular strands (Lambl's excrescences) have been, implicated in. systemic thromboembolism, we also review the available mana gement principles for patients with valvular strands; unfortunately, no spe cific therapeutic guidelines can be proposed at the present time.