Assessment of papillary fibroelastomas with live three-dimensional transthoracic echocardiography

Seven consecutive patients presenting with typical echocardiographic features of papillary fibroelastoma requiring surgery were studied. All patients underwent standard two-dimensional (2D) transthoracic echocardiography (TTE) followed by live three-dimensional (live 3D) echocardiography with data set storage allowing analysis with systematic cropping of the acquired 3D data and volume measurement of the lesions. Assessment of papillary fibroelastoma by 2D and live 3D TTE was compared to operative findings. The feasibility of live 3D echocardiography in this setting was 100%. The quality of images was considered as optimal in three patients, good in three patients, and poor in one patient. A typical speckled appearance of the tumor was observed in three patients presenting with large tumors. The location of the tumor attachment was precisely defined in all but one patient, with a clear improvement in spatial assessment with live 3D TTE in three patients. Live 3D TTE also improved the operative planning in three patients. Live 3D TTE appears to be useful in the assessment of intracardiac tumors as small as papillary fibroelastomas, leading to a comprehensive approach of the lesion and facilitating the operative planning.