A posterior mitral valve leaflet blood cyst treated with total endoscopic resection: A case report and review of literature

Abstract

Introduction: cardiac blood cyst is a very rare benign tumor of the heart in adults. Though it is very common in the first half year of life, it regresses with time and its occurrence is very rare in children older than six months and in adults. Until now less than 100 valvular blood cysts have been reported in the literature. Case presentation: We present a case of 66 years old male presented with right leg weakness for two weeks. He was diagnosed with a cardiac mass two months ago in another hospital. The physical examination was unremarkable. Abdominal ultrasound showed a cyst in the liver and left kidney. Echocardiography showed a mass-occupying lesion of a cystic nature in the mitral valve with mild mitral regurgitation. Based on echo findings and abdominal ultrasound report the preliminary diagnosis of mitral valve blood cyst was made. The patient underwent total endoscopic resection of the cyst. The posterior mitral cusp was repaired and a mitral annuloplasty ring was placed. The postoperative recovery was uneventful. The histopathology report confirmed the diagnosis of cardiac blood cyst. The patient was followed up for six months without any complications. This case is presented here to enrich the already available medical literature of the cardiac blood cyst. Conclusion: The possibility of cardiac blood cyst increases with concomitant cyst present elsewhere in the body. Though cardiac blood cyst is a rare entity in adults, it should be considered in the differential diagnosis of cardiac tumors. Because the natural history and hemodynamic effect are very diverse, large symptomatic cardiac cysts, especially in the left heart should be resected to avoid complications.