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• W2125474443 abstract "Cardiac papillary fibroelastomas are rare benign tumors that most often originate from the valvular endocardium. They are normally discovered at routine autopsy or after embolic complications have occurred [1Edwards F.H. Douglas H. Amram C. et al.Primary cardiac valve tumors.Ann Thorac Surg. 1991; 52: 1127-1131Abstract Full Text PDF PubMed Scopus (288) Google Scholar, 2Grinda J. Couetil J.P. Chauvaud S. et al.Cardiac valve fibroelastoma surgical excision for revealed or potential embolization.J Thorac Cardiovasc Surg. 1999; 117: 106-110Abstract Full Text Full Text PDF PubMed Scopus (150) Google Scholar]. The embolic material may arise from either fragments of the tumor or from thrombus that not uncommonly forms around the tumor. Because of this threat of embolic complications such as stroke or myocardial infarction, it is generally advised to perform prompt surgical resection of the tumor with preservation of the native valve [1Edwards F.H. Douglas H. Amram C. et al.Primary cardiac valve tumors.Ann Thorac Surg. 1991; 52: 1127-1131Abstract Full Text PDF PubMed Scopus (288) Google Scholar, 2Grinda J. Couetil J.P. Chauvaud S. et al.Cardiac valve fibroelastoma surgical excision for revealed or potential embolization.J Thorac Cardiovasc Surg. 1999; 117: 106-110Abstract Full Text Full Text PDF PubMed Scopus (150) Google Scholar]. Unfortunately, these severe and sometimes lethal complications are often the first symptoms of primary cardiac valve tumors. However, preoperative noninvasive echocardiographic diagnosis is feasible and can be made with a good degree of confidence [3Yee H.C. Nwosu J.E. Lii A.D. et al.Echocardiographic features of papillary fibroelastoma and their consequent management.Am J Cardiol. 1997; 80: 811-814Abstract Full Text Full Text PDF PubMed Scopus (63) Google Scholar]. In this case, an aortic valve tumor was diagnosed when the patient, a 50-year-old woman, underwent preoperative examination for a noncardiac surgical procedure. The patient had a blank history of cardiac disease and no cardiac or neurologic symptoms. Because slight electrocardiographic changes were observed, the cardiologist was consulted. A systolic murmur was heard at the apex and the second right intercostal space. Electrocardiography showed sinus tachycardia and nonspecific ST segment changes in V4 to V6. Echocardiography revealed normal left ventricular function and a tumor attached to the right coronary cusp. There was no aortic stenosis or insufficiency. The tumor had the typical echocardiographic appearance of a nonhomogenous, round, echocardiographically dense structure (Fig 1). At surgery we found a papillary tumor attached with a small stalk to the free edge of the right coronary cusp and simply excised it. The typical macroscopic appearance resembling a sea anemone is shown in Figure 2. Characteristic histopatological findings of multiple papillary fronds with a dense core of connective tissue, containing elastic fibers (Elastin van Gieson staining) covered with endothelial cells, are shown in Figure 3. Fig 2View Large Image Figure ViewerDownload (PPT)Fig 3View Large Image Figure ViewerDownload (PPT)" @default.
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• W2125474443 date "2004-02-01" @default.
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• W2125474443 title "Elective surgery for fibroelastoma of the aortic valve" @default.
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• W2125474443 doi "https://doi.org/10.1016/s0003-4975(03)00471-5" @default.
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