I doubt you have a malignancy, but there is a chance that you could have a hypercoagulable state that would predispose you to forming clots. It's hard for me to recommend what should be done next, but I think you should meet with your physicians again to determine if you do have a hypercoagulable state, whether the TEE needs to be repeated to reevaluate the fibrin strands, and whether you need a further work-up for infectious causes. Additionally, your physicians may consider changing your aspirin to a stronger blood thinner called coumadin. I hope this information helps in your quest to determine the cause of the fibrin strand on your valve. If you have further questions, please don't hesitate do write back.
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