Autologous Pericardial Patch Repair for Papillary Fibroelastoma on an Aortic Valve Leaflet

A 50-year-old man with no history of cardiovascular disease was referred to our hospital because of an abnormal electrocardiogram. Echocardiograms and computed tomograms revealed a 9-mm mass on the underside of an aortic valve leaflet. We chose surgical treatment, to prevent embolic events. The tumo...

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Bibliographic Details
Published in:Texas Heart Institute journal 2017-04, Vol.44 (2), p.144-146
Main Authors: Sakata, Tomoki, Nakaya, Mitsuru, Otsu, Masayoshi, Sunazawa, Toru, Wakabayashi, Yutaka
Format: Article
Language:English
Subjects:
Aortic Valve - diagnostic imaging
Aortic Valve - pathology
Aortic Valve - surgery
Biopsy
Cardiac Surgical Procedures - methods
Case Reports
Diagnosis, Differential
Fibroma - diagnostic imaging
Fibroma - pathology
Fibroma - surgery
Heart Neoplasms - diagnostic imaging
Heart Neoplasms - pathology
Heart Neoplasms - surgery
Heart Valve Diseases - diagnostic imaging
Heart Valve Diseases - pathology
Heart Valve Diseases - surgery
Humans
Male
Middle Aged
Papilloma - diagnostic imaging
Papilloma - pathology
Papilloma - surgery
Pericardium - transplantation
Predictive Value of Tests
Transplantation, Autologous
Treatment Outcome
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Summary:A 50-year-old man with no history of cardiovascular disease was referred to our hospital because of an abnormal electrocardiogram. Echocardiograms and computed tomograms revealed a 9-mm mass on the underside of an aortic valve leaflet. We chose surgical treatment, to prevent embolic events. The tumor's appearance and intraoperative frozen section were consistent with myxoma. We resected the tumor and its attachment, including the free margin of the aortic valve leaflet, and repaired the defect with use of a glutaraldehyde-treated autologous pericardial patch. The postoperative histopathologic diagnosis was papillary fibroelastoma. Six months later, echocardiograms showed mild aortic regurgitation and no recurrence of the aortic valve mass. Papillary fibroelastoma and myxoma can be difficult to distinguish intraoperatively, yet the diagnosis has considerable influence on the surgical strategy, including whether valve-sparing excision is an option. Therefore, it is necessary to at least suspect both entities if the tumor characteristics are unusual. This case is instructive for surgeons and pathologists.
ISSN:0730-2347
1526-6702
DOI:10.14503/THIJ-16-5822