Surgery for papillary fibroelastoma with uncommon location in left ventricle

Papillary fibroelastoma in the left ventricle

We present a 61-year-old woman with a recent transient ischemic attack who presented with presyncope and was ultimately found to have a papillary fibroelastoma at the apex of her left ventricle. She underwent minimally invasive excision of the tumor.

Cardiac papillary fibroelastoma presenting as acute stroke

We present a case of a young woman who was initially diagnosed with acute stroke with no obvious risk factors. Preliminary investigation with transthoracic echocardiography and subsequent advanced imaging with transoesophageal echocardiography suggested the diagnosis of a benign cardiac tumour on the anterior leaflet of mitral valve. The patient underwent urgent surgical resection. Histology confirmed the diagnosis of cardiac papillary fibroelastoma. She made complete clinical recovery with no recurrence of symptoms.

Left Ventricular Apical Papillary Fibroelastoma Resection via Mediastinoscope through the Aortic Valve

This case report describes a novel minimally invasive technique for complete resection of a cardiac papillary fibroelastoma by directly visualizing the mass via an intraoperative mediastinoscope placed through the aortic valve. A 68-year-old man presented to the emergency department with two episodes of transient ischemic attack. Echocardiography demonstrated a pedunculated, mobile mass in the left ventricular apex. Cardiac surgery was consulted, and complete resection of the fibroelastoma was carried out by inserting a mediastinoscope through the aortic valve and into the left ventricle, whereby the mass was directly visualized and excised with biopsy forceps. There were no postoperative complications, and at 1-year follow-up, the patient had no further evidence of embolic events.

Papillary fibroelastoma of the aortic valve--a case report and literature review

The prevalence of primary cardiac tumour ranges from 0.0017-0.28% and papillary fibroelastoma is rare but not uncommon benign cardiac neoplasm. Currently, with the advent of higher-resolution imaging technology especially transoesophageal echocardiography such cases being recognized frequently. The clinical presentation of these tumours varies from asymptomatic to severe ischaemic or embolic complications. We herein, present a 50-year-old female patient with a papillary fibroelastoma of the aortic valve arising from the endocardium of the right coronary cusp very close to the commissure between the right and non-coronary cusps. The patient presented with angina-like chest pain and was investigated using echocardiography and CT angiographic modalities in addition to the usual investigations. The differential diagnosis considered was a thrombus, myxoma, Lambl's excrescence and infective vegetation. The surgical management included a prompt resection of the tumour on cardiopulmonary bypass avoiding injury to the aortic valve. The patient recovered well. A review of the literature suggests that the cardiac papillary fibroelastoma is a rare but potentially treatable cause of embolic stroke and other fatal complications, therefore, a strong suspicion; appropriate use of imaging modality, preoperative anticoagulation and urgent surgical resection is warranted. Also, possibility of this diagnosis should be kept in mind while managing cardiac or valvular tumours.