Aortic Fibroelastoma: Detailed Preoperative Analysis with 3D Echocardiography

Abstract

A 70-year-old asymptomatic patient was referred for a transthoracic echocardiogram (TTE) for atrial fibrillation. TTE appreciated a mass in the aortic valve.3D transesophageal echocardiogram (TEE) revealed a mobile 12 9 10 mm rounded mass (*) joined to the free edge of noncoronary cusp (NcC) of the aortic valve (Fig. 1A). The image analysis, in systole, allows more detailed information (movie clips S1 and S2). The mass is attached to the free edge of the leaflet through a narrow pedicle (p) of 5 mm length by 1 mm wide (Fig. 1B, C). Aortic valve anatomy and function were normal. The diagnosis of fibroelastoma was made. Figure 1. A . En face view from ascending aorta (left) and lateral view (right) in systole and diastole. A mobile rounded mass (*) joined to the free edge of NcC can be identified. B. Two-dimensional imaging obtained from 3D echocardiogram reveals the mass attached to a narrow p. C. 3D subtraction of the mass, p and NcC. D. Intraoperative findings allow visualization of the tumor. E. The surgical piece, once removed from the aortic valve. NcC = noncoronary cusp of the aortic valve; p = pedicle of the tumor.