Papillary fibroelastoma of the aortic valve in a patient with an acute myocardial infarction

Pasteuning, W.Hans; Zijnen, P.; Aa, Miranda A.C. van der; Peters, J.; Geldorp, Theo R. van

doi:10.1016/s0894-7317(96)90488-5

Cited by 14 publications

(9 citation statements)

References 6 publications

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“…Previously, these tumors were thought to be innocuous, presenting as incidental echocardiographic or postmortem findings. However, recent reports have shown them to: produce obstruction to blood flow, contribute to myocardial ischemia and infarction, cause cerebral vascular events and pulmonary embolism . Embolization may result from fragments of the tumor, or platelet and fibrin aggregates on the tumor, dislodging into the systemic arterial circulation.…”

Section: Discussionmentioning

confidence: 99%

Rapidly Growing Cardiac Papillary Fibroelastoma in a Teenager with Sickle Cell Disease

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Rapidly Growing Cardiac Papillary Fibroelastoma in a Teenager with Sickle Cell Disease

et al. 2013

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“…Infected myxoma has been reported in 21 cases. [10][11][12][13][14][15] Shimizu et al reported in 1992 that 33% of infected myxomas was related to dental treatment, 16 suggesting that the process of infected myxomas was similar to infectious endocarditis. A similar case of left atrial hematoma infected with bacteria has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13][14][15][16][17] The present patient was given antimicrobial drugs and had the tumor resected, and was discharged without any further complications.…”

Section: Discussionmentioning

confidence: 99%

Infected Papillary Fibroelastoma Attached to the Atrial Septum.

Koji

Fujioka

Imai

et al. 2002

Circ J

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rimary tumors of the heart are rare and are often classified histologically as 'benign'. One-sixth of these are papillary fibroelastomas, which usually originate in the heart valves. 1 A few previous reports have shown papillary fibroelastomas arising from the mural endocardium of the heart chambers, papillary fibroblastomas attached to the atrial septum are extremely rare. 2 Case ReportA 61-year-old woman was in good health until 2 months prior to admission to the Yamamoto General Hospital in June 1998. On admission she complained of progressive fatigue. The week before, she had had intermittent fever peaking at 39.5°C and 2 months prior she had had a tooth extraction.On physical examination, the patient was anxious, but did not appear to be ill. Her body temperature was 39.2°C, pulse rate was 84 beats/min, respiratory rate was 16 breaths/min and her blood pressure was 108/80 mmHg. The first and second heart sounds were normal with no gallop. A grade 2/6 mid-systolic murmur was heard at the apex. The lungs were clear on auscultation. The abdominal examination was unremarkable and the extremities showed no clubbing, edema, arthritis, Osler's nodes, or Janeway lesions. Neurological examination was unremarkable. Two-dimensional echocardiography showed a 5.0×1.5 cm heavy stick-like mass attached to the atrial septum, in the left atrium during ventricular systole and passing freely into the left ventricle in diastole. The head of the mass had a high-density echo that was thought to be vegetation (Fig 1) A 61-year-old woman had intermittent fever of 2 months' duration following a dental extraction. On admission, her body temperature was 39.2°C. A mid-systolic murmur was heard at the apex on ausculation. A 2-dimensional echocardiogram revealed a mobile, heavy stick-like mass with vegetation (5.0×1.5 cm) attached to the left atrial septum. Multiple blood cultures grew Streptococcus constellatus. On diagnosis of an infected left atrial myxoma, antibiotics were administered daily and 4 weeks later, the left atrial tumor was resected. The tumor was 5.3 cm long, 1.5 cm in diameter at the inter-atrial wall and had vegetation on the free edge. On microscopic examination, colonies of Gram-positive cocci were found in the thrombus, on the papillary fibroelastoma. After treatment with antibiotics for a further 4 weeks, the patient was discharged. This is the first report of infected papillary fibroelastoma.

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“…1 Before the 1980s, most fibroelastomas were found at autopsy, 2,15,16,19,28,29 but since then, an increasing number of papillary fibroelastomas have been detected preoperatively. 3,5,7,8,12,26,32,33 Angiography 5,26,30,32,34 or magnetic resonance imaging 35 can reveal fibroelastoma, but echocardiography has been the most widely used modality; not only transthoracic, but also transesophageal, 9,11,13,20,[36][37][38][39][40][41][42] which also proved useful in our patient for finding the cause of the TIA. The evolution of echocardiography will increase the chance of detecting fibroelastoma preoperatively and further our knowledge of the characteristics of fibroelastoma.…”

Section: Discussionmentioning

confidence: 99%

Papillary Fibroelastoma of the Aortic Valve: Report of a Case

et al. 2002

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This report describes a case of aortic papillary fibroelastoma causing transient ischemic attack (TIA), and is followed by a review of the relevant literature. A tumor measuring 1.5 x 1.5 cm was located in the right coronary cusp of the aortic valve, which was found to have a "sea anemone-like" configuration due to collagenous or elastic papillary projections. Aortic fibroelastoma can cause cerebrovascular symptoms, and this patient presented with TIA. Moreover, aortic fibroelastoma usually causes chest symptoms and occasionally results in death despite its small size of generally less than 1 cm. According to the literature, all of the patients who died of fibroelastoma had an aortic valve tumor in the right or left coronary cusp, which indicates that the location of the tumor rather than its size may be an important factor contributing to the case of death. Surgical treatment is usually indicated especially for aortic fibroelastoma because of the high associated risk or cerebrovascular and chest diseases. The recent evolution of echocardiography will promote the chance of establishing a preoperative diagnosis of this lesion. However, because it is not possible to differentiate fibroelastoma from other lesions, including malignancies, by echocardiography alone, this may be another reason for performing surgical removal.

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Papillary fibroelastoma of the aortic valve in a patient with an acute myocardial infarction

Cited by 14 publications

References 6 publications

Rapidly Growing Cardiac Papillary Fibroelastoma in a Teenager with Sickle Cell Disease

Rapidly Growing Cardiac Papillary Fibroelastoma in a Teenager with Sickle Cell Disease

Infected Papillary Fibroelastoma Attached to the Atrial Septum.

Papillary Fibroelastoma of the Aortic Valve: Report of a Case

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