Surgical Management of an Incidental Aortic Valve Papillary Fibroelastoma: A Case Report

Papillary fibroelastoma (PFE) is an uncommon benign primary cardiac tumor whose detection has increased with the widespread use of advanced cardiac imaging, particularly transesophageal echocardiography and cardiac magnetic resonance imaging. Its clinical expression is heterogeneous, ranging from incidental findings in asymptomatic individuals to serious complications related to embolic events or myocardial ischemia. Surgical excision remains the definitive treatment to eliminate this risk. We report the case of a 69-year-old woman with a medical history of diabetes mellitus, hypertension, and coronary artery disease previously managed with percutaneous stenting of the right coronary artery and the left anterior descending artery. During routine follow-up, transesophageal echocardiography revealed an incidental mass arising from the aortic valve, specifically from the arterial aspect of the non-coronary cusp. The main differential diagnoses included thrombus, myxoma, and infective endocarditis vegetation. The patient underwent successful complete excision of the lesion under cardiopulmonary bypass, with preservation of native aortic valve function.