title: Papillary fibroelastoma: clinical and echocardiographic features and initial approach in 54 cases.
abstract: BACKGROUND
  Papillary fibroelastoma (PFE) is a benign cardiac tumor that is currently detected more often due to the technological improvements in echocardiography.
  
  
  OBJECTIVE
  To describe the echocardiographic features of PFE and correlate them with the clinical presentation and initial treatment.
  
  
  METHODS
  A prospective analysis of patients with a diagnosis of PFE was conducted between 2000 and 2015. We assessed the clinical history, symptoms at the time of diagnosis, echocardiographic features, and initial treatment.
  
  
  RESULTS
  Fifty-four patients with a diagnosis of PFE by echocardiography were included. The incidence was 0.038%. Mean age was 62±16 years; 50% were male. Forty-six percent of patients had symptoms at the time of diagnosis, the most frequent of which was transient ischemic accident (TIA). Embolic episodes occurred in 31% of patients, mainly to the brain. PFEs were valvular in 70.4% of cases and multiple in 13%. Mean maximum length was 1.18±0.58 cm, and 44% were mobile. PFEs >1.5 cm were most often found in the heart valves (56.8% vs 10.8%; P=.045). There was no significant relation between size, mobility, location and number of tumors, and the presence of embolism or symptoms. Most frequent treatment was oral anticoagulation in 48.6%, followed by simple tumor resection in 42.8% of cases.
  
  
  CONCLUSIONS
  PFE is a small tumor, predominantly valvular and benign, but entails a high incidence of cerebral embolism. The initial approach should be individualized according to clinical manifestations, comorbidities, and the experience of the surgical center.
authors: Echocardiography Laboratory, Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich,", Buenos Aires, Argentina.
authors: Tomás Francisco
authors: TF
authors: Cianciulli
authors: Echocardiography Laboratory, Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich,", Buenos Aires, Argentina.
authors: Juan Bautista
authors: JB
authors: Soumoulou
authors: Echocardiography Laboratory, Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich,", Buenos Aires, Argentina.
authors: Jorge Alberto
authors: JA
authors: Lax
authors: Echocardiography Laboratory, Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich,", Buenos Aires, Argentina.
authors: María Cristina
authors: MC
authors: Saccheri
authors: Echocardiography Laboratory, Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich,", Buenos Aires, Argentina.
authors: Alberto
authors: A
authors: Cozzarin
authors: Echocardiography Laboratory, Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich,", Buenos Aires, Argentina.
authors: Martín Alejandro
authors: MA
authors: Beck
authors: Echocardiography Laboratory, Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich,", Buenos Aires, Argentina.
authors: Daniel Ernesto
authors: DE
authors: Ferreiro
authors: Echocardiography Laboratory, Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich,", Buenos Aires, Argentina.
authors: Horacio Alberto
authors: HA
authors: Prezioso
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D015150:Echocardiography, Doppler / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000601:surgery; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010210:Papillary Muscles; D011446:Prospective Studies
keywords: cardiac surgery; embolism; papillary fibroelastoma