title: Resection of left ventricular fibroma with subacute papillary muscle rupture.
abstract: Cardiac fibroma is a rare, benign tumor that occurs chiefly in children and rarely in adults. Most fibromas occur in the ventricles and may reach a very large size that complicates surgical removal. Herein, we report the case of a 38-year-old woman who presented with shortness of breath, fatigue, and lightheadedness and was found to have a 6 × 8-cm fibroma of the left ventricle. Surgical resection was successful, but 7 days later she developed sudden-onset severe mitral regurgitation due to partial disruption of the posterolateral papillary muscle. Mitral valve replacement with a 27-mm mechanical valve was performed. Five years later, the patient remained well, without evident tumor recurrence or cardiac dysfunction.Mitral valve dysfunction with regurgitation has been reported to occur before, immediately after, and late after the resection of left ventricular fibromas. To our knowledge, this is the 1st report of subacute papillary muscle rupture after the resection of a left ventricular fibroma. This case highlights the need to evaluate mitral valve function by carefully inspecting the resection margins after surgery and interpreting the echocardiographic results during the acute, subacute, and late time frames.
authors: Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston 77030, USA.
authors: Monika J
authors: MJ
authors: Leja
authors: Lynda
authors: L
authors: Perryman
authors: Michael J
authors: MJ
authors: Reardon
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005350:Fibroma / Q000473:pathology / Q000601:surgery*; D006338:Heart Neoplasms / Q000473:pathology / Q000601:surgery*; D006341:Heart Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014463:Ultrasonography