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Papillary Fibroelastoma Incidentally Found on Left Atrial Wall During Minimally Invasive Aortic Valve Replacement.
Qasim Al Abri1, Lamees I El Nihum1, M Mujeeb Zubair1
1Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, Texas.
Texas Heart Institute Journal
|August 22, 2022
Summary
A rapidly growing cardiac mass, initially undetected, was discovered during surgery. This papillary fibroelastoma highlights the need for vigilance in cardiac procedures.
Area of Science:
- Cardiovascular Surgery
- Cardiac Pathology
- Diagnostic Imaging
Background:
- Minimally invasive aortic valve replacement is a standard procedure.
- Intracardiac masses can pose diagnostic and surgical challenges.
Observation:
- A 60-year-old man presented for aortic valve replacement; transesophageal echocardiography revealed a new left atrial mass.
- Previous imaging 5 months prior showed no such intracardiac mass.
Findings:
- The surgical team converted the minimally invasive procedure to open surgery.
- The excised mass, initially suspected as myxoma, was histopathologically identified as a papillary fibroelastoma.
- This indicates rapid formation and growth of the papillary fibroelastoma.
Implications:
- Papillary fibroelastomas can develop and enlarge quickly, unlike typical presentations.
- Clinicians must maintain high suspicion for unexpected intracardiac masses before and during cardiac surgery.
- This case underscores the importance of multimodal imaging and intraoperative vigilance in cardiac procedures.
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