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Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
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Operative management of cardiac papillary fibroelastomas

Piotr Mazur1, Reto Kurmann2, Kyle W Klarich2

  • 1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.

The Journal of Thoracic and Cardiovascular Surgery
|August 21, 2022
PubMed

Insights

Surgical excision of papillary fibroelastomas, a heart tumor linked to stroke risk, is safe and effective. Outcomes are excellent whether the surgery is primary or secondary, with low complication rates.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Oncology
  • Neurosurgery

Background:

  • Papillary fibroelastomas are rare cardiac tumors.
  • These tumors are associated with a significant risk of embolic strokes.
  • Surgical excision is the definitive treatment, either as a primary procedure or secondarily during other cardiac operations.

Purpose of the Study:

  • To summarize the surgical experience with papillary fibroelastomas.
  • To evaluate outcomes of primary versus secondary excision.
  • To assess the safety and efficacy of papillary fibroelastoma resection.

Main Methods:

  • Retrospective analysis of medical records from January 1998 to February 2020.
  • Inclusion of patients who underwent surgical excision of papillary fibroelastoma.
  • Evaluation of patient demographics, tumor characteristics, surgical indications, and short- and long-term outcomes.

Main Results:

  • 294 patients were analyzed; 46% had primary excision, 54% secondary.
  • 51% of patients had a history of stroke or transient ischemic attack.
  • Low operative mortality (0% primary vs. 2.5% secondary) and early neurologic events (1.3%).
  • 10-year recurrence rate was 15.8%.
  • 10-year survival was 78.4% for primary and 53.6% for secondary excision.

Conclusions:

  • Resection of papillary fibroelastomas is safe and feasible.
  • Native valve preservation is often possible.
  • Low rates of neurologic events and excellent long-term outcomes support surgical intervention.
Abstract

Keywords:
PFEaortic valvecardiac surgeryfibroelastomaheartpapillary fibroelastomatumor

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