[Left ventricular papillary fibroelastomas without relation to a heart valve--a report of 2 cases]

Papillary fibroelastomas are rare benign tumors of the heart. We report about two cases in which these tumors do not--as characteristically--arise from a heart valve but originate from the free wall of the left ventricle. In the case of a 74-year-old woman with signs of a cerebral ischemia in the vascular system of the A. cerebri posterior, the tumor was resected transaortically. At a 67-year-old patient with symptoms of instable angina pectoris and increasing dyspnoea echocardiography or coronary angiography showed an aortic stenosis III degrees, a coronary artery disease as well as a tumor within the region of the apex of the left ventricle. Beside a fourfold aortocoronary venous bypass and an aortic valve replacement tumor excision via left ventriculotomy was carried out. In the diagnostics of intracardiac tumors transthoracic and transesophageal echocardiography provide the methods of choice to visualize quickly and noninvasively the extent, mobility, and origin of the tumor. Considering the systemic thromboembolic potential with the high risk of cerebrovascular respectively neurological symptoms total surgical tumor excision is clearly indicated.