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Scanning Electron Microscopy of Macerated Tissue to Visualize the Extracellular Matrix
Published on: June 14, 2016
Multiple cardiac papillary fibroelastomas and rheumatic heart disease
J M Kalman1, S Lubicz, J B Brennan
1Cardiology Department, Austin Hospital, Heidelberg, Victoria, Australia.
Australian and New Zealand Journal of Medicine
|October 1, 1991
Summary
This study reports a rare case of multiple papillary fibroelastomas found on the mitral valve in a patient with rheumatic mitral stenosis. Echocardiography and surgery confirmed the diagnosis and complete removal of these cardiac tumors.
Area of Science:
- Cardiology
- Pathology
- Cardiac Surgery
Background:
- Rheumatic heart disease commonly affects the mitral valve, leading to stenosis.
- Papillary fibroelastomas are rare cardiac tumors, typically found as single lesions.
Observation:
- Preoperative 2-dimensional echocardiography revealed multiple echodense masses on the mitral valve and papillary muscle in a patient with severe rheumatic mitral stenosis.
- Intraoperative transesophageal echocardiography confirmed complete excision of these masses during mitral valve replacement surgery.
Findings:
- Histologic examination of the excised masses confirmed the diagnosis of papillary fibroelastomas.
- This case represents the first documented instance of multiple papillary fibroelastomas associated with rheumatic valvular disease, visualized preoperatively via echocardiography.
Implications:
- Highlights the importance of thorough echocardiographic evaluation in rheumatic heart disease for detecting co-existing cardiac tumors.
- Suggests a potential, though unproven, association between valvular inflammation/damage and the development of multiple fibroelastomas.
- Emphasizes the role of advanced imaging and surgical intervention in managing complex cardiac conditions involving both valvular disease and tumors.
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