scholarly journals Nonsurgical Management of a Papillary Fibroelastoma of the Aortic Valve

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Antonino M. Grande ◽  
Nicoletta Castiglione ◽  
Adelaide Iervolino ◽  
Francesco Nappi ◽  
Antonio Fiore
Keyword(s):  
Aortic Valve ◽  
Standard Of Care ◽  
Surgical Excision ◽  
Papillary Fibroelastoma ◽  
Surgical Removal ◽  
Nonsurgical Management ◽  
Asymptomatic Patients ◽  
Coronary Cusp ◽  
The Right ◽  
Right Coronary Cusp

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.

Resting angina due to papillary fibroelastoma of the right coronary cusp

2014 ◽  
Vol 31 (1) ◽  
pp. 114-117 ◽  
Author(s):  
Eiji Taguchi ◽  
Koichi Nakao ◽  
Toshiharu Sassa ◽  
Takihiro Kamio ◽  
Mina Sakanashi ◽  
...  
Keyword(s):  
Papillary Fibroelastoma ◽  
Coronary Cusp ◽  
The Right ◽  
Right Coronary Cusp

scholarly journals Automatic Aortic Valve Cusps Segmentation from CT Images Based on the Cascading Multiple Deep Neural Networks

2022 ◽  
Vol 8 (1) ◽  
pp. 11
Author(s):  
Gakuto Aoyama ◽  
Longfei Zhao ◽  
Shun Zhao ◽  
Xiao Xue ◽  
Yunxin Zhong ◽  
...  
Keyword(s):  
Neural Networks ◽  
Aortic Valve ◽  
Deep Neural Networks ◽  
Spatial Configuration ◽  
Ct Images ◽  
Anatomical Landmarks ◽  
Strong Correlations ◽  
Coronary Cusp ◽  
The Right ◽  
Right Coronary Cusp

Accurate morphological information on aortic valve cusps is critical in treatment planning. Image segmentation is necessary to acquire this information, but manual segmentation is tedious and time consuming. In this paper, we propose a fully automatic aortic valve cusps segmentation method from CT images by combining two deep neural networks, spatial configuration-Net for detecting anatomical landmarks and U-Net for segmentation of aortic valve components. A total of 258 CT volumes of end systolic and end diastolic phases, which include cases with and without severe calcifications, were collected and manually annotated for each aortic valve component. The collected CT volumes were split 6:2:2 for the training, validation and test steps, and our method was evaluated by five-fold cross validation. The segmentation was successful for all CT volumes with 69.26 s as mean processing time. For the segmentation results of the aortic root, the right-coronary cusp, the left-coronary cusp and the non-coronary cusp, mean Dice Coefficient were 0.95, 0.70, 0.69, and 0.67, respectively. There were strong correlations between measurement values automatically calculated based on the annotations and those based on the segmentation results. The results suggest that our method can be used to automatically obtain measurement values for aortic valve morphology.

scholarly journals Role of imaging for diagnosis and management of aortic valve papillary fibroelastoma and cardiac AL amyloidosis: A case report

2021 ◽  
Author(s):  
Ivan Dimov ◽  
Nathalie Meuleman ◽  
Didier de Cannière ◽  
Philippe Unger
Keyword(s):  
Aortic Valve ◽  
Cardiac Function ◽  
Cardiac Amyloidosis ◽  
Global Longitudinal Strain ◽  
Surgical Excision ◽  
Papillary Fibroelastoma ◽  
Uneventful Recovery ◽  
Optimal Timing ◽  
Surgical Removal ◽  
Al Amyloidosis

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.

Easy Placement of Annular Sutures during Minimally Invasive Aortic Valve Replacement

2017 ◽  
Vol 12 (3) ◽  
pp. 227-229 ◽  
Author(s):  
Toshinori Totsugawa ◽  
Arudo Hiraoka ◽  
Kentaro Tamura ◽  
Hidenori Yoshitaka ◽  
Taichi Sakaguchi
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Left Ventricular ◽  
Surgical Field ◽  
Coronary Cusp ◽  
Hemodynamic Performance ◽  
The Right ◽  
Right Coronary Cusp

Placing annular sutures at the right coronary cusp is difficult during minimally invasive aortic valve replacement. We propose the partial everting mattress method, whereby a prosthetic valve is implanted ina supra-annular position at the left coronary and noncoronary cusps, with pledgets on the left ventricular side, but in an intra-annular position at the right coronary cusp, with pledgets on the aortic side. Needles can be grasped in forehand pass at all three coronary cusps. Our method enables easy placement of annular stitches even in the small surgical field, without adversely influencing the hemodynamic performance of the prosthesis.

Papillary Fibroelastoma of the Right Coronary Cusp

2010 ◽  
Vol 13 (5) ◽  
pp. E330-E332
Author(s):  
Orhan Saim Demirtürk ◽  
Hüseyin Ali Tünel ◽  
Öner Gülcan ◽  
Isa Coşkun
Keyword(s):  
Papillary Fibroelastoma ◽  
Coronary Cusp ◽  
The Right ◽  
Right Coronary Cusp

Two- and Three-Dimensional Transesophageal Echocardiography for Aortic Valve Aneurysms on the Right Coronary Cusp

2013 ◽  
Vol 116 (4) ◽  
pp. 784-787 ◽  
Author(s):  
Masataka Kuroda ◽  
Akihito Takemae ◽  
Toshikazu Takahashi ◽  
Norikatsu Mita ◽  
Shin Kagaya ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transesophageal Echocardiography ◽  
Three Dimensional ◽  
Coronary Cusp ◽  
The Right ◽  
Right Coronary Cusp

scholarly journals Left Ventricular Chord Masquerading As An Aortic Valve Papillary Fibroelastoma

2021 ◽  
Author(s):  
Fatima M Ezzeddine ◽  
Melanie C Bois ◽  
Sorin V Pislaru ◽  
Hartzell V Schaff
Keyword(s):  
Aortic Valve ◽  
Multimodality Imaging ◽  
Surgical Excision ◽  
Left Ventricular ◽  
Papillary Fibroelastoma ◽  
Aortic Sinus ◽  
Acute Infarction ◽  
Coronary Cusp ◽  
Cardiac Masses

Abstract Background Characterization of cardiac masses and anomalies is challenging and usually requires multimodality imaging. Herein, we present the case of a left ventricular chord masquerading as an aortic valve papillary fibroelastoma. Case summary In this case, a 62-year-old woman presented with acute right foot weakness. Brain imaging showed multiple areas of acute infarction concerning for a cardioembolic stroke. Transesophageal echocardiography revealed a mass, which was thought to be a papillary fibroelastoma, attached to the non-coronary cusp of the aortic valve. The patient underwent surgical excision of the mass which turned out to be a left ventricular chord crossing the aortic valve and attaching to the left aortic sinus of Valsalva. Conclusion This case underlines the importance of close examination of the aortic subvalvular apparatus when assessing aortic valve masses.

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