Papillary Fibroelastoma Complicated with Ischemic Heart Disease and Arteriosclerosis Obliterans Treated Successfully by Surgery

(Department of Cardiovascular Surgery, Kyoto University Hospital, Kyoto, Japan, Department of Cardiovascular Surgery, Rakuwakai Otowa Hospital*, Kyoto, Japan, Department of Cardiovascular Surgery, Mitsubishi Kyoto Hospital**, Kyoto, Japan and Department of Cardiovascular Surgery, Nagahama Municipal Hospital***, Nagahama, Japan)

Takeshi Shimamoto Toshifumi Takeuchi* Hiroyuki Nakajima**
Akiyoshi Mikuriya*** Motoyuki Oda
A 67-year-old man had been followed up in our cardiology clinic for ischemic foot, and routine echocardiography revealed an 8~9mm highly echogenic mass on the mitral posterior leaflet. Because of the high thromboembolic risk, open-heart surgery was scheduled for surgical treatment of the tumor. His preoperative coronary angiogram showed 3 vessel disease. Coronary artery bypass grafting and tumor removal were performed consequently. His postoperative course was uneventful and the lesion was pathologically diagnosed a papillary fibroelastoma. No recurrence has occurred one year after the operation. Surgical treatment of cardiac tumors is mandatory for preventing embolism regardless of the size and location. Most of the tumors on cardiac valves are papillary fibroelastomas and recurrence of this tumor has not been reported so far. When the tumor is attached to a mitral leafet, simple tumor resection, with or without mitral valve repair, is justified instead of performing mitral replacement with en bloc resection of tumors and the entire leaflets.
@Jpn. J. Cardiovasc. Surg. 36: 12-14 (2007)