A Surgical Case of Papillary Fibroelastoma Located in the Tricuspid Valve Chordae

Ko Nakahara	Hirohisa Goto	Megumi Fuke
Masayuki Sakaguchi	Kazunori Nishimura

（Department of Cardiovascular Surgey, Nagano Red Cross Hospital, Nagano, Japan）

Papillary fibroelastoma（PFE）is the second most common type of benign cardiac tumor after myxoma, and is most commonly found in the left side of the heart. In this study, we report a case of PFE located in the tricuspid valve chordae. The patient was a 65-year-old woman in whom a heart murmur was detected during a routine medical examination. A follow-up examination identified a cardiac tumor, and she was subsequently referred to our medical department. Echocardiography and contrast-enhanced computed tomography indicated a mobile mass of approximately 1 cm in the right ventricle, and she was determined to be a candidate for surgery. After cardiopulmonary bypass, we instigated cardioplegic arrest, made an incision in the right atrium, and observed the right ventricle through the tricuspid valve. We observed a yellowish sea-anemone-like mass approximately 9 mm from the chordae of the anterior leaflet of the tricuspid valve. Thus, the mass was resected with the chordae and tricuspid annuloplasty. Postoperative progress was satisfactory, and the subject was discharged on the 19th day of hospitalization. Histopathological examination indicated a mixture of thick fibrous and adipose tissues, which led to the diagnosis of PFE. PFE is a relatively rare disease that comprises 8% of primary cardiac tumors. IA often occurs in the left heart and can cause cerebral infarction, myocardial infarction, and other symptoms of embolism. However, because small masses and those that occur in the right heart are not accompanied by clinical symptoms, such cases are often discovered during routine echocardiography. The present study reports a case of PFE that occurred in the tricuspid valve chordae that was diagnosed via echocardiography.

 

Jpn. J. Cardiovasc. Surg. 44:338-341（2015）

Keywords：papillary fibroelastoma;cardiac tumor;tricuspid valve