A Case of Multiple Cardiac Papillary Fibroelastoma in the Aortic Valve

Takehiro Kubota＊

Yasushige Shingu＊＊

Satoru Wakasa＊＊

（Department of Cardiovascular Surgery, NHO Hakodate National Hospital＊, Hakodate, Japan, and Graduate School of Medicine, Hokkaido University＊＊, Sapporo, Japan）

We report a case of multiple papillary fibroelastoma（PFE）on the aortic valve. A healthy woman in her 60s was referred to a nearby doctor with the chief complaint of palpitation and was admitted to our hospital for detailed examination. A mobile tumor was found by transthoracic echo, and she was introduced to us. We undertook excision surgery for her. Initially, it was thought to be a single tumor, and a pedunculated tumor adhering to the central aortic side of the left coronary cusp with a length of 7mm was removed. After closing the aorta, we recognized a remaining mobile tumor by transesophageal echo. We decided to perform cardiac arrest again, and we recognized one tumor with 6mm long string-like mobile mass on the right and non-coronary commissure of cardiac side, and a thorn-like mass of about 1.5mm on the non-coronary cusp of the cardiac side. We removed both tumors from the aortic valve using shaving resection and preserved the aortic valve. All of these were found to be PFE pathologically as if they were three tumors that followed the developmental stage of PFE. After surgery, PFE recurrence is extremely rare. In the case of a pedunculated tumor, it is possible to remove the tumor and preserve the valve. However, as in this case, if both sides of the valve were not carefully inspected, it can be overlooked. In addition, small tumor resection could avoid the risk of new cerebral infarction and myocardial infarction due to recurrence and could avoid reoperation.

 

Jpn. J. Cardiovasc. Surg. 50:270-273（2021）

Keywords：cardiac tumor;papillary fibroelastoma;recurrence