Papillary fibroelastoma: retrospective analysis. Clinical presentation and surgical results

BOBADILLA P; GUEVARA E; DULBECCO E; CASABE JH; ABUD J; VIGLIANO C; SALMO F; FAVALORO RR

MEDICINA (BUENOS AIRES)

MEDICINA (BUENOS AIRES)

Lugar: Buenos Aires; Año: 2017 vol. 77 p. 481 - 485

0025-7680

Papillary  fibroelastomas are small benign intracardiactumors known for their embolic potential. Since the introduction ofechocardiography with improved resolution and transesophageal imagingtechniques, they are being increasingly detected in clinical practice. Inrecent series, papillary fibroelastoma is considered the most frequent benigntumor of the heart. Our objective was to analyze characteristics and midtermsurgical outcome of histologically-confirmed cases of papillary fibroelastoma.We conducted a retrospective study on patients with cardiac tumors submitted tosurgical excision between June 1992 and February 2017. Out of 108 patients, 18had papillary fibroelastomas. Their mean age was 58 years (22-77); 10 were men.The most frequent localizations were the aortic valve (7) and the mitral valve(5). None had significant valvular dysfunction. By transesophagealechocardiography, the tumor size (larger diameter) was 13.33 ± 5.55 mm(6.6-28.0). Two patients, both with tumor in the aortic valve, had suffered astroke; other two had dyspnoea and atrial flutter, respectively. The remaining14 patients were asymptomatic and their tumors were incidental findings. In 15patients the valve was preserved. There was neither surgical mortality norrecurrence after 2.6 years of follow-up. In conclusion, most papillaryfibroelastomas can be surgically removed with valve preservation and favorableclinical outcome. However, until the results of randomized trials support thedecision, an aggressive surgical approach in asymptomatic patients needs to bedefined in the context of surgical expertise.