Key result
Resecting a giant pulmonary valve lipoma with bicuspidization preserves biventricular function and minimizes regurgitation.
Why the study?
Primary valvular lipomas are very rare, with spindle-cell varieties previously described only in the aortic valve.
Case Report (n=1)
Total resection and bicuspidization is a viable and effective treatment for the extremely rare presentation of a pulmonary valve spindle-cell lipoma.
Documents rare pulmonary valve spindle-cell lipoma; leaves open questions on natural history and management.
Primary cardiac tumours are rare and most of them are benign. Myxomas, fibroelastomas and lipomas are common in adults. Primary valvular cardiac tumours are even more rare and affect all four valves in a similar proportion. Valvular lipomas are very rare. In the pulmonary valve there is only one described. Lipomas can be spindle-cell varieties. But of these, there is only one described in a valve, and it is placed in the aortic valve. Pulmonary valve lipomas can produce obstruction to the right ventricular outflow tract as well as pulmonary valve regurgitation, or pulmonary embolism. Symptoms may be dyspnoea, angina, arrhythmias, or syncope. We aim to illustrate with this case report how we came into this very rare pathology, so we present a 54-year-old woman with a giant spindle-cell lipoma located in the anterior pulmonary leaflet and severe dyspnoea. Total resection of the tumour was performed and restoration of valve function was obtained by means of bicuspidization of the remaining pulmonary leaflets. She had a good recovery after surgery and no complication during the postoperative evolution, being discharged from hospital after 7 days from surgery, with echocardiographic control showing good biventricular function, absence of tumour or obstruction, and minimal pulmonary valve regurgitation.
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Sauchelli-Faas et al. (2023) conducted a case report in Pulmonary valve spindle-cell lipoma (n=1). Total resection of the tumour and bicuspidization of the remaining pulmonary leaflets was evaluated on Recovery and valve function. Total resection of a giant spindle-cell lipoma in the pulmonary valve with bicuspidization resulted in good biventricular function and minimal regurgitation at 7 days.
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