scholarly journals Concomitant tumourous lesions in the left atrium and aortic valve suspected to be myxoma

2019 ◽  
Vol 57 (5) ◽  
pp. 1011-1012 ◽  
Author(s):  
Yuriy Mandryk ◽  
Markus Czesla ◽  
Christian Flora ◽  
Parwis Massoudy
Keyword(s):  
Aortic Valve ◽  
Left Atrium ◽  
Cardiac Myxoma ◽  
Transoesophageal Echocardiography ◽  
Papillary Fibroelastoma ◽  
Single Patient ◽  
Non Invasive ◽  
Cardiac Tumours ◽  
Multiple Primary ◽  
Diagnostic Modalities

Abstract The occurrence of multiple primary cardiac tumours in a single patient is extremely rare. Despite growing expertise in non-invasive diagnostic modalities, especially in transoesophageal echocardiography, only a few cases report the coincidence of papillary fibroelastoma of the aortic valve and myxoma of the left atrium. Moreover, echocardiographic as well as a macroscopic distinction between cardiac myxoma and cardiac fibroelastoma may be difficult. Only post-excisional histopathology provides diagnostic safety. Cryoablation of the remnant tissue prevents recurrence in both the aortic valve and the left atrium.

scholarly journals Clinical and echocardiographic characteristics of patients with pathology proven left-sided non-valvular papillary fibroelastoma

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E El-Am ◽  
A Ahmad ◽  
R Kurmann ◽  
A Sorour ◽  
M Bois ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Papillary Fibroelastoma ◽  
Left Ventricular Outflow

Abstract Funding Acknowledgements Type of funding sources: None. Background Papillary fibroelastoma (PFE) is now regarded as the most common primary tumor of the heart. Although benign, they are clinically significant for their high risk of embolization. They are most commonly found on cardiac valves but can also be present on non-valvular endocardial surfaces. The aim of this study was to better characterize patients with left-sided non-valvular PFE and its clinical sequelae. Methods We retrospectively identified patients with pathology-proven PFEs at a single center between January 1995 and December 2018 (n = 279). Patients with left-sided non-valvular PFE were analyzed. Medical records were retrospectively reviewed for clinical characteristics and outcomes. In addition, intra-operative transesophageal echocardiograms were manually reviewed to estimate overall size and location. Results During the study period, we identified 37 patients with left-sided non-valvular PFE (mean age 61 ± 14 years; 62% females) (Table). PFEs were located on the left ventricle in 41%, left atrium in 35%, and left ventricular outflow tract in 24% of patients. Around a quarter of patients (27%) had a diagnosis of hypertrophic cardiomyopathy, 19% had prior cardiac surgery, and 27% had cancer diagnosed prior to PFE diagnosis. Transient ischemic attack or stroke was the presenting symptom in 22% of patients, myocardial infarction in 6% and peripheral embolization in 6%. Median maximal length for PFE on the left ventricle was 11.1 mm [3;18], on the left atrium 9 mm [2;25], and left ventricular outflow tract 8 mm [6;13]. A minority of patients (9/37 [24%]) had associated valvular PFE on the mitral valve and/or aortic valve (1 patient had both mitral valve and aortic valve PFE, 7 had aortic valve PFE and 1 had Mitral valve PFE). Only 13 patients had follow up transthoracic/transesophageal echocardiogram 1 year after PFE removal; 4/13 (31%) had documented PFE recurrence (3 PFE recurred in the same location as the original; 1 in a different location). Conclusion Left-sided non-valvular PFE is associated with thromboembolic events and at least in those that had follow-up echocardiograms, had a high recurrence rate. More studies are needed to evaluate the management of patients with asymptomatic PFE. Abstract Figure. Baseline Characteristics

Benign cardiac tumours

ESC CardioMed ◽  
2018 ◽  
pp. 1612-1617
Author(s):  
Cristina Basso ◽  
Stefania Rizzo ◽  
Martina Perazzolo Marra ◽  
Marialuisa Valente ◽  
Gaetano Thiene
Keyword(s):  
Left Atrium ◽  
Benign Tumour ◽  
Papillary Fibroelastoma ◽  
Age Group ◽  
Cardiac Tumours ◽  
Paediatric Age

Primary cardiac tumours are mostly benign (90%) and myxoma is by far the most frequent benign tumour (75%). It is typically located in the left atrium, and manifests with intracavitary obstruction, embolism, and constitutional symptoms but may be also silent and discovered incidentally by echocardiography. Papillary fibroelastoma is the second most frequent and, although quite small, may become symptomatic through embolic events. Typical tumours of the paediatric age group are fibromas, rhabdomyomas, and teratomas.

scholarly journals Unicuspid aortic valve: a rare congenital anomaly

Cardiology ◽  
2021 ◽  
Author(s):  
Jianhong Pan
Keyword(s):  
Aortic Valve ◽  
Three Dimensional ◽  
Treatment Modalities ◽  
Accurate Identification ◽  
Non Invasive ◽  
First Choice ◽  
Valvular Function ◽  
Dimensional Echocardiography ◽  
Diagnostic Modalities ◽  
Three Dimensional Echocardiography

Unicuspid aortic valve (UAV) is a rare congenital aortic valve anomaly. It has two subtypes and often is associated with aortic valve dysfunction and corresponding clinical presentations. Echocardiography is the first choice of diagnostic method for UAV. Three-dimensional echocardiography has played an increasingly important role in diagnosis, intraprocedural guidance, and post-procedural assessment in recent years. There remain challenges in distinguishing UAV from bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV). Misdiagnosis is most resulted from raphes or leaflet calcifications. Multi-modality imaging has obvious advantages over single-modality imaging and is crucial for UAV diagnosis. Accurate identification of aortic valve morphology is important to choose the best treatment. Aortic balloon valvoplasty, surgical valvotomy, commissurotomy, Ross procedure, surgical valve repair and surgical replacement are most common treatment modalities of UAV. In this review, we aim to discuss UAV including epidemiology, definition, classification, diagnostic importance and necessity, valvular function, clinical presentation, associated disorders, non-invasive diagnostic modalities and therapeutic approaches.

scholarly journals An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Niamh Logan ◽  
Mohammad Sirajul Islam ◽  
Jehan Zeb Chughtai ◽  
Niamh F Murphy
Keyword(s):  
Myocardial Infarction ◽  
Aortic Valve ◽  
Troponin I ◽  
Case Series ◽  
High Sensitivity ◽  
Papillary Fibroelastoma ◽  
Cardiac Tumours ◽  
Systemic Embolization ◽  
Increased Risk ◽  
Benign Tumours

Abstract Background Papillary fibroelastomas are rare primary cardiac tumours with a prevalence of 0.01% at autopsy. They are histologically benign tumours but have been demonstrated through case series to confer an increased risk of thrombo-embolism resulting in: transient ischaemic attack, stroke, myocardial infarction, and pulmonary and systemic embolization. Case summary A 54-year-old woman presented with central chest pain radiating to her left arm. At presentation there was a significant troponin rise; initial high-sensitivity troponin-I (hsTn-I) 660 pg/mL increased to 3340 pg/mL at 6 h. Coronary angiogram did not reveal any obstructing coronary artery disease. Echocardiography revealed a rounded, mobile mass on the left coronary cusp of the aortic valve suspicious for papillary fibroelastoma. The patient underwent shave excision of the lesion. Intra-operatively it was noted that the mass intermittently sat within the ostium of the left main resulting in its occlusion. Histology confirmed a papillary fibroelastoma. Discussion Primary cardiac tumours are rare but can cause life-threatening complications such as stroke, myocardial infarction, and cardiac arrest. In the literature, the mechanism of these complications is mainly attributed to thrombo-embolism. This case demonstrates the utility of echocardiogram in investigating and diagnosing a rare cause of myocardial infarction and highlights an unusual mechanism, that is tumour causing obstruction of the coronary ostium.

scholarly journals Cardiac Myxomas: A Histodemographic Analysis

2018 ◽  
Vol 6 (1) ◽  
pp. 4-8
Author(s):  
Afia Akhter ◽  
Nadira Majid ◽  
Syed Salahuddin Ahmed ◽  
Kuazi Dil Afroz ◽  
Md Rezwanur Rahman ◽  
...  
Keyword(s):  
Left Atrium ◽  
Autosomal Dominant ◽  
Cardiac Myxoma ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Cardiac Tumours ◽  
Natural Behaviour ◽  
Female Predominance ◽  
Cardiac Myxomas

Background: Cardiac myxoma is the most common benign cardiac tumour, accounting for more than half of all primary cardiac tumours. Most myxomas are sporadic and the cause is largely unknown. Familial variants with an autosomal dominant inheritance exist. It is localized generally in the left atrium and typically develops in females. Clinical manifestations can mimic cardiac conditions and depend on the natural behaviour of the tumour and its location within the heart, ranging from being completely asymptomatic to causing sudden death. Establishing an early diagnosis is essential, which is confirmed by histopathology.Objective: The aim was to find the relation between cardiac myxomas with age, sex and cardiac sites.Materials and method: This cross sectional study was done in the pathology department of Delta Hospital Limited, Dhaka, Bangladesh, during the period of January 2014 to July 2016. A total of 24 cases were studied irrespective of age, sex along with clinical diagnosis.Results: Among the study subjects females were predominant (70.83%) and highest frequency of cases occurred in between 41-50 years of age (41.67%). Commonest site was left atrium (83.33%).Conclusion: The present study revealed that cardiac myxoma occurs most commonly in the 5th decade with female predominance and the most common site is left atrium.Delta Med Col J. Jan 2018 6(1): 4-8

scholarly journals Left Atrium Papillary Fibroelastomas: A Cause of Cerebral Emboli

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
A. G. Ciss ◽  
P. S. Ba ◽  
P. A. Dieng ◽  
K. Azarnoush ◽  
L. Camilleri ◽  
...  
Keyword(s):  
Left Atrium ◽  
Surgical Resection ◽  
Cerebral Circulation ◽  
Cardiac Tumor ◽  
Transoesophageal Echocardiography ◽  
Papillary Fibroelastoma ◽  
Cerebral Embolization ◽  
Mobile Mass ◽  
Benign Cardiac Tumor ◽  
Benign Tumours

Papillary fibroelastomas are cardiac benign tumours. Among the benign cardiac tumor, papillary fibroelastomas are reported second after myxomas. Most often diagnosed incidentally, papillary fibroelastomas may embolize to cerebral circulation. Valvular locations are predominant; location in left atrium is rare. In this paper, we present a case of papillary fibroelastoma located in left atrium with symptoms of cerebral embolization. Transoesophageal echocardiography diagnosed a mobile mass. The patient was treated with surgical resection without further embolic complication.

scholarly journals Safe Transcatheter Aortic Valve Replacement in a Patient with a Highly Mobile Aortic Valve Mass

2018 ◽  
Vol 27 (03) ◽  
pp. 174-176
Author(s):  
Brian Agbor-Etang ◽  
Ashis Mukherjee ◽  
Prabhdeep Sethi ◽  
Ramdas Pai
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Cardiac Valve ◽  
Papillary Fibroelastoma ◽  
Transcatheter Aortic Valve ◽  
Nonsurgical Patient

AbstractSome cardiac valve masses may have embolic potential with worrisome consequences. We describe the dilemmas of and solutions for a highly mobile papillary fibroelastoma on the aortic valve in a nonsurgical patient undergoing transcatheter aortic valve replacement. It was performed safely. The potential strategies to minimize the risk of embolization are discussed.

scholarly journals Real-time observation of a high-echoic mass in the left ventricle during transcatheter aortic valve implantation: a case report

2020 ◽  
Author(s):  
Akiko Masumoto ◽  
Takeshi Kitai ◽  
Mitsuhiko Ota ◽  
Kitae Kim ◽  
Natsuhiko Ehara ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Transcatheter Aortic Valve Implantation ◽  
Severe Aortic Stenosis ◽  
Cerebral Arteries ◽  
Transoesophageal Echocardiography ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background Increasing number of symptomatic patients with severe aortic stenosis is treated with transcatheter aortic valve implantation (TAVI). Stroke is one of the most serious complications of TAVI, and the majority of cerebral events in patients undergoing TAVI have an embolic origin. Case summary A 90-year-old female underwent trans-femoral TAVI for symptomatic severe aortic stenosis. Just before the implantation of the transcatheter heart valve (THV), transoesophageal echocardiography (TOE) showed a mobile, high-echoic mass attached to the THV, which gradually enlarged to 26 mm, then spontaneously detached from the THV and flowed up the ascending aorta, disappearing from the TOE field of. After the procedure, the patient presented with ischaemic stroke. The patient’s stroke was thought to have resulted from the embolism migrating to the distal cerebral arteries. Discussion The detailed images acquired with TOE during TAVI enabled the prompt identification of the unusual intracardiac mass.

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