Ovidiu Stiru1,2, Roxana Carmen Geana1, Petru Razvan Dragulescu1, Adrian Tulin3,4, Laura Raducu5,6, Nicolae Bacalbasa7,8,9, Irina Balescu10, Dragos Cretoiu11,12, Camelia Diaconu13,14, Laura Iliescu13,15, Cornel Savu2,16, Vlad Anton Iliescu1,2. 1. Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania. 2. Department of Cardio-Thoracic Pathology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 3. Department of Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 4. Department of General Surgery, Prof. Dr. Agripa Ionescu, Clinical Emergency Hospital, Bucharest, Romania. 5. Department of Plastic and Reconstructive Microsurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 6. Department of Plastic and Reconstructive Surgery, Prof Dr. Agripa Ionescu, Clinical Emergency Hospital, Bucharest, Romania. 7. Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania nicolae_bacalbasa@yahoo.ro. 8. Department of Obstetrics and Gynecology, I. Cantacuzino Clinical Hospital, Bucharest, Romania. 9. Department of Visceral Surgery, Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania. 10. Department of Surgery, Ponderas Academic Hospital, Bucharest, Romania. 11. Department of Cellular, Molecular and Histology Biology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 12. Scientific researcher, Alessandrescu-Rusescu National Institute of Mother and Child Health, Fetal Medicine Excellence Research Center, Bucharest, Romania. 13. Department of Internal Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 14. Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, Bucharest, Romania. 15. Department of Internal Medicine, Fundeni Clinical Institute, Bucharest, Romania. 16. Department of Thoracic Surgery, Marius Nasta Institute of Pneumonology, Bucharest, Romania.
Abstract
BACKGROUND/AIM: Cardiac papillary fibroelastomas (CPF) are benign tumors, frequently asymptomatic, characterized by a mobile pedunculated mass that arises from the endocardium. When CPF is located in the left ventricle, it may protrude into the left ventricular outflow tract and affect hemodynamics. They are highly thrombogenic, and can also cause some life-threatening events such as cerebral and peripheral embolization. CASE REPORT: We herein report a case of a 74-year-old female admitted to our center with palpitations and dyspnea on exertion. Her past medical history revealed that she had had a transient ischemic attack 7 months before presentation. Echocardiography and cardiac magnetic resonance imaging revealed an intracardiac mass anchored in the anteroapical interventricular septum without interference with aortic or mitral valve functionality. Surgical resection of the left ventricular mass was performed through the left apical ventriculotomy approach. Histopathological examination of the tumor was suggestive of papillary fibroelastoma. The postoperative course was uneventful. The patient was discharged home on the eighth postoperative day, with no recurrence at 6 months. CONCLUSION: Although left ventricular papillary fibroelastomas are benign tumors, they carry a high risk for embolic complications and therefore surgery should be proposed, the transapical approach being a safe and effective method. Copyright
BACKGROUND/AIM: Cardiac papillary fibroelastomas (CPF) are benign tumors, frequently asymptomatic, characterized by a mobile pedunculated mass that arises from the endocardium. When CPF is located in the left ventricle, it may protrude into the left ventricular outflow tract and affect hemodynamics. They are highly thrombogenic, and can also cause some life-threatening events such as cerebral and peripheral embolization. CASE REPORT: We herein report a case of a 74-year-old female admitted to our center with palpitations and dyspnea on exertion. Her past medical history revealed that she had had a transient ischemic attack 7 months before presentation. Echocardiography and cardiac magnetic resonance imaging revealed an intracardiac mass anchored in the anteroapical interventricular septum without interference with aortic or mitral valve functionality. Surgical resection of the left ventricular mass was performed through the left apical ventriculotomy approach. Histopathological examination of the tumor was suggestive of papillary fibroelastoma. The postoperative course was uneventful. The patient was discharged home on the eighth postoperative day, with no recurrence at 6 months. CONCLUSION: Although left ventricular papillary fibroelastomas are benign tumors, they carry a high risk for embolic complications and therefore surgery should be proposed, the transapical approach being a safe and effective method. Copyright