Key result
Surgical excision of cardiac papillary fibroelastomas resulted in no operative or tumor-related late mortality, though asymptomatic metachronous tumor recurrence was detected by transesophageal echocardiography in 17% of patients.
Why the study?
Limited contemporary data were available regarding clinical and echocardiographic outcomes following surgery for cardiac papillary fibroelastoma.
Observational (n=12)
No
Surgical excision of cardiac papillary fibroelastomas is safe and effective, but long-term follow-up with transesophageal echocardiography is necessary due to the risk of asymptomatic recurrence.
Small CPF cohort suggests acceptable surgical safety; leaves open optimal timing and embolization risk stratification.
AIMS: Limited contemporary data are available on the clinical and echocardiographic outcomes after surgery for cardiac papillary fibroelastoma (CPF). The aim of this study was to review the clinical manifestations, pathological characteristics, surgical management, and prognoses of patients with histologically verified CPF, who underwent surgery at our cardiac surgery center from 2008 to 2018. METHODS AND RESULTS: Twelve patients of median age 62 years (28 to 77 years) were treated. Embolic stroke or transient ischemic attack (five patients, 42%) were the only CPF clinical manifestations. Eleven (92%) tumors were localized on the valves, with the aortic valve being the most common tumor site (seven patients; 58%). Multiple factor analysis revealed no independent predictor of CPF-related embolization. Simple shave tumor excision was sufficient in most patients (10 patients, 83%). No operative or tumor-related late mortality during the median follow-up period of 4.7 years (1.1 to 10.2 years) was recorded. Asymptomatic metachronous valve tumor recurrence (in a location different from that of the original tumor) was revealed in two patients (17%) by transesophageal echocardiography (TEE), not detected by transthoracic echocardiography (TTE). One of these two patients underwent repeated surgery for CPF but later suffered a recurrent embolic stroke, due to another tumor recurrence. CONCLUSION: CPF can be safely and effectively treated surgically. TEE is superior to the TTE option in CPF post-operative recurrence detection. There is a clear need for a prospective study to determine criteria for embolization risk stratification and optimum management in patients with CPF.
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Kolek et al. (2019) conducted an observational in Cardiac papillary fibroelastoma (n=12). Surgical excision was evaluated on Tumor recurrence detected by transesophageal echocardiography (TEE). Surgical excision of cardiac papillary fibroelastomas resulted in no operative or tumor-related late mortality, though asymptomatic metachronous tumor recurrence was detected by transesophageal echocardiography in 17% of patients.
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