title: Aortic valve repair for papillary fibroelastoma.
abstract: We report the case of aortic valve-papillary fibroelastoma in a 66-year-old Belgian woman with a previous single episode of cerebral transient ischemic attack. Transthoracic two-dimensional echocardiography revealed a small mass adherent to the noncoronary cusp of the valve, which was confirmed by transesophageal echocardiography. Indication for surgery was performed because of a previous cerebral transient ischemic attack and for its potential risk of cerebral and coronary embolization. Surgical excision of the mass was performed with the need for glutaraldehyde-treated autologous pericardial patch repair of the aortic cusp. Intraoperative and postoperative transesophageal echocardiography both showed the valve to be competent. Postoperative recovery was uneventful. After a review of the literature, we conclude that, even if asymptomatic, and independent of their size, aortic valve papillary fibroelastomas justify surgical excision for their potential to systemic embolization. Moreover, we believe that a valve-sparing approach might be feasible with no recurrence after complete excision.
authors.affiliation: Cliniques Universitaires St Luc, Service de Chirurgie Cardiovasculaire et Thoracique, Brussels, Belgium. ludima08@libero.it
authors.forename: Luca
authors.initials: L
authors.lastname: Di Marco
authors.forename: Amin
authors.initials: A
authors.lastname: Al-Basheer
authors.forename: David
authors.initials: D
authors.lastname: Glineur
authors.forename: Guido
authors.initials: G
authors.lastname: Oppido
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Bartolomeo
authors.forename: Gebrine
authors.initials: G
authors.lastname: El-Khoury
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D003323:Coronary Aneurysm; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004695:Endocardial Fibroelastosis / Q000473:pathology; D005260:Female; D005350:Fibroma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*