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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Left Atrium Cardiac Papillary Fibroelastoma in Patient With Atrial Fibrillation

Suma Gondi1, Matthew Dandan1, Julie A Hansen2

  • 1Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

JACC. Case Reports
|July 17, 2026
PubMed

Insights

Cardiac papillary fibroelastoma (CPFE), a rare heart mass, was found in the left atrium. Combined surgery for CPFE and atrial fibrillation led to complications, suggesting staged procedures may reduce risks.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardiovascular Imaging

Background:

  • Cardiac papillary fibroelastoma (CPFE) are rare cardiac masses.
  • They are associated with serious cardiovascular events including myocardial infarction, syncope, arterial embolism, and sudden death.
  • Left atrial CPFE is an uncommon presentation.

Purpose of the Study:

  • To report a case of left atrial CPFE in an elderly patient undergoing evaluation for Watchman device implantation and Cox-Maze procedure.
  • To discuss the implications of combined CPFE excision and atrial fibrillation surgery.

Main Methods:

  • Transthoracic echocardiogram to identify the left atrial mass.
  • Combined surgical excision of the left atrial CPFE and Cox-Maze procedure for atrial fibrillation.
  • Postoperative monitoring for complications.

Main Results:

  • A 1.2-cm CPFE was identified in the left atrium of an 87-year-old woman.
  • The patient developed cardiogenic shock and atrial fibrillation recurrence postoperatively.
  • The combined procedure carried significant risks.

Conclusions:

  • Left atrial CPFE is rare and requires careful consideration for combined surgical procedures.
  • Manipulation of the left atrium during CPFE excision may increase the risk of postoperative atrial fibrillation.
  • Staged procedures might be a safer alternative to reduce the risk of atrial fibrillation recurrence.
Abstract

Keywords:
atrial fibrillationmitral valverobotic surgery

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