Cardiac valve papillary fibroelastoma: surgical excision for revealed or potential embolization.
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.
Grinda
J M
JM
Department of Cardiovascular Surgery of Broussais Hospital [1], Paris, France.
Couetil
J P
JP
Chauvaud
S
S
D'Attellis
N
N
Berrebi
A
A
Fabiani
J N
JN
Deloche
A
A
Carpentier
A
A
D000328:Adult; D000368:Aged; D017548:Echocardiography, Transesophageal; D005260:Female; D005350:Fibroma / Q000601:surgery*; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies