Publication Date

4-1-2016

Journal

The Texas Heart Journal

DOI

10.14503/THIJ-14-4889

PMID

27127431

Publication Date(s)

April 2016

Language

English

PMCID

PMC4845562

PubMedCentral® Posted Date

4-1-2016

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Cardiac surgical procedures, fibroma/complications/diagnosis/pathology/surgery, heart neoplasms/diagnosis/surgery/ultrasonography, retrospective studies, treatment outcome

Abstract

In general, treatment for symptomatic and asymptomatic cardiac papillary fibroelastoma is surgical resection-particularly of left-sided lesions, because of the risk of systemic embolization. However, few institutions have enough experience with these tumors to validate this approach. We present our institutional experience with papillary fibroelastoma and discuss our current approach. We searched our institution's cardiac tumor database, identified all patients diagnosed with cardiac papillary fibroelastoma from 1992 through 2014, and recorded the clinical and pathologic characteristics of each case. We found 14 patients (mean age, 60.5 ± 12.3 yr) who had 18 lesions. Eleven patients (79%) were symptomatic; however, we could not always definitively associate their symptoms with a cardiac tumor. Most lesions were solitary and ≤1.5 cm in diameter; half involved the left side of the heart. All 18 lesions were surgically excised. There were no operative or 30-day deaths, and no patient needed valve replacement postoperatively. There was one late death; at one year, another 3 patients were lost to follow-up, and the others were alive without tumor recurrence. Because of the embolic risk inherent to intracardiac masses and our relatively good postoperative outcomes, we recommend the surgical resection of all left-sided papillary fibroelastomas in surgical candidates, and we discuss with patients the advisability of resecting right-sided lesions.

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