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Dumbor L. Ngaage
Charles J. Mullany
Richard C. Daly
Joseph A. Dearani
William D. Edwards
Christopher G.A. McGregor
Thomas A. Orszulak
Francisco J. Puga
Hartzell V. Schaff
Thoralf M. Sundt, III
Kenton J. Zehr
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Right arrow Cardiac - other

Ann Thorac Surg 2005;80:1712-1718
© 2005 The Society of Thoracic Surgeons

Original article: Cardiovascular

Surgical Treatment of Cardiac Papillary Fibroelastoma: A Single Center Experience With Eighty-Eight Patients

Dumbor L. Ngaage, MB, BS a , Charles J. Mullany, MB, MS a , * , Richard C. Daly, MD a , Joseph A. Dearani, MD a , William D. Edwards, MD b , Henry D. Tazelaar, MD b , Christopher G.A. McGregor, MD a , Thomas A. Orszulak, MD a , Francisco J. Puga, MD a , Hartzell V. Schaff, MD a , Thoralf M. Sundt, III, MD a , Kenton J. Zehr, MD a

a Division of Cardiovascular Surgery, Mayo Medical Center, Rochester, Minnesota
b Division of Anatomic Pathology, Mayo Medical Center, Rochester, Minnesota

Accepted for publication April 22, 2005.

* Address correspondence to Dr Mullany, Division of Cardiovascular Surgery, St. Mary's Hospital, Rochester, MN 55902 (Email: cmullany{at}mayo.edu).

Presented at the Poster Session of the Forty-first Annual Meeting of The Society of Thoracic Surgeons, Tampa, FL, Jan 24–26, 2005.

BACKGROUND: Cardiac papillary fibroelastoma is a rare benign tumor that can cause thromboembolism. We have found no large surgical series describing its treatment and outcome.

METHODS: A retrospective review of all patients treated surgically for this tumor from 1985 to 2002.

RESULTS: There were 88 patients with a mean age of 62 ± 16 years. Sixty-two (71%) were male. Cardiac papillary fibroelastoma was a primary indication for surgery in 47 (group 1, 53%) and an incidental finding in 41 (group 2, 47%). The common clinical symptoms were neurologic (group 1) and cardiac (group 2). Cardiac valves were predominantly involved (77%); the aortic valve was the most affected (52%). Other common sites were the left ventricular outflow tract (18%) and anterior mitral leaflet (11%). All heart valves were involved in one patient. Seventy-three patients (83%) had shave excision and 8 (9%) excision with valve repair. Of 5 (6%) valve replacements, 2 were for concurrent degenerative valve disease. Concomitant procedures included repair or replacement of another valve (32 %), CABG (28%), and septal myectomy (19%). Surgical mortality occurred in 1 patient (2.1%) in group 1 who had concomitant lung resection for bronchiolitis obliterans. There was no tumor recurrence, and no tumor-related late morbidity or mortality at a mean follow-up of 3 years.

CONCLUSIONS: Cardiac papillary fibroelastoma has a propensity to affect the anatomically contiguous structures of the aortic valve, left ventricular outflow tract, and anterior mitral leaflet. Surgical treatment by simple shave excision is low risk and can achieve good results.




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