Papillary fibroelastoma of the aortic valve: Analysis of 21 cases, including a presentation with cardiac arrest

Hirohisa Ikegami*, Adin Cristian Andrei, Zhi Li, Patrick M. McCarthy, S. Chris Malaisrie

*Corresponding author for this work

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Cardiac papillary fibroelastoma is a rare, benign tumor, arising predominantly from cardiac valves. This tumor can cause a variety of symptoms due to thromboembolism. We describe our single-center surgical experience with papillary fibroelastoma of the aortic valve. From April 2004 through June 2013, 6,530 patients underwent cardiac surgery. Of those, 6,098 patients were included in the final analysis. Twenty-one patients (0.34%) underwent surgical resection of 30 papillary fibroelastomas of the aortic valve. Most patients (67%) were incidentally diagnosed to have cardiac papillary fibroelastoma. The usual symptom was cerebral infarction (in 5 of 7 symptomatic patients). A rare presentation of papillary fibroelastoma in one patient was cardiac arrest caused by left main coronary artery ostial obstruction. Tumor size was not related to patient age (Pearson correlation coefficient, 0.34; P=0.13). Neither the number of tumors (1.43 ± 0.72 vs 1.43 ± 0.62) nor tumor size (8.14 ± 2.42 vs 8.07 ± 3.31 mm) was significantly different between symptomatic and asymptomatic patients. All lesions were resected by means of the simple shave technique. There were no operative or 30-day deaths. Follow-up echocardiograms showed no tumor recurrence (mean follow-up duration, 17 ± 14 mo). We identified no significant relationship among tumor size, number of tumors, symptoms, or patient age. Because simple shave excision of the tumor can be safely achieved without evidence of tumor recurrence, we conclude that surgical resection can be reasonable in asymptomatic patients.

Original languageEnglish (US)
Pages (from-to)131-135
Number of pages5
JournalTexas Heart Institute Journal
Volume42
Issue number2
DOIs
StatePublished - Jan 1 2015

Keywords

  • Aortic valve/ surgery
  • Cardiac surgical procedures
  • Chest pain/etiology
  • Fibroma/complications/ diagnosis/pathology/surgery
  • Heart neoplasms/complications/ surgery/ultrasonography
  • Heart valve diseases/ pathology
  • Myocardial infarction/ etiology
  • Retrospective studies
  • Treatment outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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