This case illustrates a thrombus within the non-coronary aortic valve cusp. The thickened adjacent leaflet towards its annular attachment raises the possibility of a previous valvulopathy. This patient was not in a hypercoagulable state or had any known infection process.

Native aortic valve thrombosis is rare.

Possible causes to explain the thrombus are thrombosis as a result of endovascular iatrogenic trauma to the valve endothelium, antibodies related to an autoimmune condition, tumoral related thrombus (marantic endocarditis), and pro-coagulable states (e.g. antiphospholipid syndrome).