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J Thorac Cardiovasc Surg 1999;117:106-110
© 1999 Mosby, Inc.

SURGERY FOR ADULT CARDIOVASCULAR DISEASE

CARDIAC VALVE PAPILLARY FIBROELASTOMA: SURGICAL EXCISION FOR REVEALED OR POTENTIAL EMBOLIZATION

From the Department of Cardiovascular Surgery of Broussais Hospital [1], Paris, France.

Received for publication June 29, 1998. Accepted for publication Aug 12, 1998. Address for reprints: Jean-Michel Grinda, MD, Départment of Cardiovascular Surgery, Broussais Hospital, 96 rue Didot, 75014 Paris, France.

Objective: We have reviewed the case histories of 4 patients who underwent operations between September 1994 and November 1997 at Broussais Hospital for cardiac valvular papillary fibroelastoma.
Methods: Diagnosis was strongly suggested by echocardiography. Tumor locations were mitral (1), tricuspid (1), and aortic (2). Indications for operation were previous stroke for the mitral tumor, prophylaxis for the tricuspid tumor, syncopal episodes for the first aortic tumor, and transient ischemic attack and mesenteric ischemia for the second aortic tumor.
Results: Surgical excision with a conservative, valve-sparing approach was performed in all cases. For the first aortic tumor, aortic valve reconstruction was achieved with part of a cryopreserved aortic homograft cusp. Intraoperative transesophageal echocardiography showed no evidence of valvular regurgitation after excision in all cases. All patients had uneventful postoperative recoveries. No evidence of regurgitation or recurrence was seen on echocardiography at follow-up.
Conclusions: Despite their histologically benign aspect, cardiac papillary fibroelastomas should be excised because of potential embolic complications. A conservative, valve-sparing approach is recommended, however, because of the absence of recurrence after total excision.

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