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Papillary fibroelastoma of the aortic valve presenting with myocardial infarction
F S Eckstein1, H J Schäfers, J Grote
1Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany.
Insights
A papillary fibroelastoma on the aortic valve caused a patient's myocardial infarction. Surgical removal of the tumor and aortic valve repair successfully treated the condition.
Area of Science:
- Cardiology
- Cardiac Surgery
- Pathology
Background:
- Intracardiac tumors are rare, with papillary fibroelastomas being the most common primary cardiac tumor.
- Papillary fibroelastomas, particularly those on the aortic valve, can pose a significant embolic risk.
- Myocardial infarction can rarely be caused by coronary embolism from cardiac tumors.
Observation:
- A 56-year-old woman presented with symptoms of myocardial infarction.
- Diagnostic investigations identified a papillary tumor on the aortic valve as the source of coronary embolism.
- Histopathological examination confirmed the tumor to be a papillary fibroelastoma.
Findings:
- Surgical excision of the papillary fibroelastoma was performed.
- The defect in the aortic valve leaflet was repaired using autologous pericardium.
- Successful reconstruction of the aortic valve was achieved.
Implications:
- This case highlights papillary fibroelastoma as a potential, albeit uncommon, cause of myocardial infarction.
- Surgical management, including tumor excision and valve repair, is effective for treating symptomatic intracardiac papillary fibroelastomas.
- Early diagnosis and intervention are crucial for preventing embolic complications and improving patient outcomes.
Abstract:
We describe the case of a 56-year-old woman who presented with myocardial infarction. Noninvasive and invasive investigations revealed coronary embolism from a papillary tumor attached to the right coronary cusp of the aortic valve as the underlying process. The tumor, which histologically proved to be a papillary fibroelastoma, was excised surgically and the resulting defect in the aortic valve leaflet was closed with a patch of autologous pericardium, effectively reconstructing the aortic valve. The current literature on intracardiac papillary fibroelastoma as a source of embolism and its surgical treatment is summarized.