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Surgery for Valvular and Nonvalvular Papillary Fibroelastomas.

Anthony Alozie1, Annette Zimpfer2, Andreas Erbersdobler2

  • 1Rostock Heart Center, Department of Cardiac Surgery, University of Rostock, Rostock, Germany.

Seminars in Thoracic and Cardiovascular Surgery
|May 22, 2021
PubMed
Summary
This summary is machine-generated.

Surgical excision of left-sided papillary fibroelastomas (PFE) is strongly advocated due to their high embolic potential, regardless of size. This 27-year study highlights the risks associated with these benign cardiac neoplasms.

Keywords:
PFEPapillary fibroelastomaPrimary heart tumorStroke

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Oncology
  • Pathology

Background:

  • Papillary fibroelastomas (PFE) are benign cardiac neoplasms with a significant embolic risk.
  • Most PFEs are found on heart valves, but nonvalvular locations also occur.

Purpose of the Study:

  • To evaluate the institutional experience with surgical treatment of PFE in adults.
  • To analyze clinicopathological features, outcomes, and embolic potential of valvular and nonvalvular PFEs.

Main Methods:

  • Retrospective analysis of cardiac surgery patients with suspected cardiac tumors between 1991 and 2018.
  • Histological confirmation of 21 PFEs in 16 patients.
  • Evaluation of clinical data, imaging, surgical procedures, and long-term follow-up.

Main Results:

  • Nonvalvular PFEs were larger than valvular PFEs (P = 0.0013).
  • Left-sided PFEs, both valvular and nonvalvular, showed a high rate of embolization (77%).
  • One in-hospital mortality; most patients discharged post-operatively with a median follow-up of 2.8 years.

Conclusions:

  • Nonvalvular PFEs can be larger and embolize as frequently as valvular PFEs.
  • Surgical excision is strongly recommended for all left-sided PFEs due to high embolic risk.