Resection of a left ventricular apical papillary fibroelastoma via a mediastinoscope through the aortic valve is a feasible minimally invasive technique.
May be feasible in select cases; hypothesis-generating and should not yet change practice.
This case report describes a novel minimally invasive technique for complete resection of a cardiac papillary fibroelastoma by directly visualizing the mass via an intraoperative mediastinoscope placed through the aortic valve. A 68-year-old man presented to the emergency department with two episodes of transient ischemic attack. Echocardiography demonstrated a pedunculated, mobile mass in the left ventricular apex. Cardiac surgery was consulted, and complete resection of the fibroelastoma was carried out by inserting a mediastinoscope through the aortic valve and into the left ventricle, whereby the mass was directly visualized and excised with biopsy forceps. There were no postoperative complications, and at 1-year follow-up, the patient had no further evidence of embolic events.
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Toeg et al. (2012) studied this question.
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