scholarly journals Surgical removal of an exceedingly rare papillary fibroelastoma of the aortic wall causing unstable angina

2021 ◽  
Vol 9 (9) ◽  
Author(s):  
Paolo Masiello ◽  
Angelo Catalano ◽  
Generoso Mastrogiovanni ◽  
Geppina Eusebio ◽  
Anna Maria De Roberto ◽  
...  
Author(s):  
Paolo Masiello ◽  
Angelo Catalano ◽  
Generoso Mastrogiovanni ◽  
Geppina Eusebio ◽  
Anna Maria De Roberto ◽  
...  

Papillary fibroelastomes are rare benign neoformations usually originating from the valvular endocardium, presenting with cerebral ischemia and/or myocardial infarction due to embolization from the mass. We report an exceedingly rare case of aortic wall papillary fibroelastoma simulating unstable angina, diagnosed with trans-thoracic/trans-esophageal echocardiography and CT scan and surgically successfully removed


2009 ◽  
Vol 87 (6) ◽  
pp. 1953-1954 ◽  
Author(s):  
Can Yerebakan ◽  
Andreas Liebold ◽  
Gustav Steinhoff ◽  
Christian Alfons Skrabal

Author(s):  
Ivan Dimov ◽  
Nathalie Meuleman ◽  
Didier de Cannière ◽  
Philippe Unger

Abstract Background We report the case of a patient who presented with concomitant aortic valve papillary fibroelastoma and cardiac amyloidosis. Although histologically benign, papillary fibroelastoma confers an increased thromboembolic risk, and surgical excision is often indicated. However, outcomes of cardiac surgery are poor in patients with cardiac amyloidosis. Case summary A 61-year old man with complaints of dyspnoea and weight loss of 10 kg developing over the past five months was evaluated in the cardiology clinic. Echocardiography revealed sessile aortic valve papillary fibroelastoma and was also highly suggestive of cardiac amyloidosis. The diagnosis of amyloid light chain amyloidosis secondary to indolent multiple myeloma was eventually confirmed. Therapy with daratumumab, bortezomib, cyclophosphamide and dexamethasone allowed full remission over a six month period and resulted in marked improvement in symptoms and cardiac function as evaluated by global longitudinal strain. Further workup with cerebral magnetic resonance revealed multiple vascular sequelae. Surgical removal of the aortic fibroelastoma with bioprosthetic aortic valve replacement was performed successfully and the patient had an uneventful recovery. Discussion Papillary fibroelastoma and cardiac amyloidosis are rare and most likely unrelated entities. Concomitant presentation of both conditions in the same patient presents a unique therapeutic challenge. By allowing cardiac function to be monitored during chemotherapy, speckle tracking echocardiography can prove instrumental in determining the optimal timing of surgical intervention.


2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Antonino M. Grande ◽  
Nicoletta Castiglione ◽  
Adelaide Iervolino ◽  
Francesco Nappi ◽  
Antonio Fiore

We report the case of a 63-year-old woman who had an incidental echocardiographic diagnosis of papillary fibroelastoma (PFE) of the right coronary cusp of the aortic valve. The patient was informed about the embolic risk due to the pedunculated mass located on the aortic valve but she refused the proposed surgical removal. She was followed up yearly, and each follow-up included an echocardiographic evaluation of the mass. The lady is taking lysine acetylsalycilate 160 mg daily, and after more than 19 years later, she does not complain any symptoms or complications as a result of possible embolic episodes. If on one hand, our report is provocative for PFE nonsurgical management; on the other, we do believe that in symptomatic patients PFE located in the left heart chambers, the standard of care remains surgical excision after diagnosis. Anyway, our analysis shows that further data in this issue are needed in asymptomatic patients, and surgical indication should be proposed considering carefully the risk-benefit balance.


Author(s):  
Hemant Chaturvedi

Cardiac papillary fibroelastoma (CPF) is the most common valvular tumour of the heart and the second most common primary cardiac tumour. Fewer than 50 cases being reported in the literature [1]. As the advancement in 3D echocardiography, its diagnosis in living patient is become easy. The CPF could be found on valve leaflets, chordae tendineae, and both ventricles. We present an interesting case of the CPF originating from the posterior leaflet of the mitral valve confusing with vegetation or annular calcification. The patient underwent successful surgical removal of the PFE


2020 ◽  
Vol 30 (5) ◽  
pp. 762-764
Author(s):  
Majdi Gueldich ◽  
Mariantonietta Piscitelli ◽  
Haytham Derbel ◽  
Khaoula Boughanmi ◽  
Eric Bergoend ◽  
...  

Abstract A floating thrombus in the ascending aorta is rarely found in clinical practice and is an uncommon cause of peripheral arterial embolization. When there is minimal atherosclerosis or a normal aorta, the management of such a lesion is poorly defined. Currently, there is no clear consensus concerning optimal treatment. Herein, we report 2 cases of ascending aortic thrombus that are complicated by a peripheral embolic event. Due to the risk of recurrent systemic embolism, particularly with strokes, surgical thrombectomy with ascending aortic wall replacements was performed. We believe that floating ascending aorta thrombus represents a serious source of systemic embolism and stroke. Surgical removal is easy to perform with good clinical outcomes. Conservative treatments such as anticoagulation or thromboaspiration may be considered in high-risk or inoperable patients.


2013 ◽  
Vol 146 (1) ◽  
pp. e1-e3 ◽  
Author(s):  
Jose María González-Santos ◽  
María Elena Arnáiz-García ◽  
María del Carmen Vargas-Fajardo ◽  
Antonio Arribas-Jiménez

Author(s):  
Claudia Calia ◽  
Vittoria Lodo ◽  
Guglielmo Actis Dato ◽  
Gianfranco Cappuccio ◽  
Enrico Italiano ◽  
...  

Background and aim Papillary fibroelastoma (PFE) represents only 16% of the benign cardiac tumor and approximately 15% of these are located on tricuspid valve. Materials and Methods Over a period of 22 years (1999-2021) we observed 75 pts with cardiac tumors at our Center over 9650 pts operated on. Most of them were mixoma but in 10 cases histology showed a PFE. We describe a rare case (1/75 of cardiac tumors) of a tricuspid valve PFE in a 69-year-old patient. Trans-thoracic echocardiography demonstrated a mobile mass (20 x 10 mm), adhering to the atrial side of the septal leaflet of the tricuspid valve. In consideration of the mobility of the mass and the consequent high embolic risk, surgical removal was made. Patient underwent surgery through a median sternotomy on CPBP. A “gelatinous” mass adhering to the tricuspid leaflet was found and completely removed. The postoperative course was uneventful. The pathological evaluation confirmed the diagnosis of PFE. Conclusions PFE of the tricuspid valve is rare entities being in most cases found incidentally. In our experience the incidence of this tumor in this location is 1/10000 cases of cardiac surgery. Although most patients are asymptomatic, surgical treatment is nevertheless recommended in consideration of the high embolic risk.


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