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Ann Thorac Surg 2007;84:1396-1397
© 2007 The Society of Thoracic Surgeons
Department of Cardiac Surgery, Laval Hospital, Québec City, Québec, Canada
Accepted for publication May 18, 2007.
* Address correspondence to Dr Dagenais, Department of Cardiac Surgery, Laval Hospital, 2725 Chemin Sainte-Foy, Québec, G1V 4G5, Canada (Email: francois.dagenais{at}chg.ulaval.ca).
Papillary fibroelastomas have been increasingly described since the widespread use of cardiac echocardiography. Most often diagnosed incidentally, papillary fibroelastomas may embolize, mainly to the cerebral circulation. The aortic valve is predominantly affected. The left ventricle is the most frequent nonvalvular location. We present a case of a 59-year-old man who had recurrent episodes of cerebral ischemic attacks and required coronary artery bypass surgery. The overall neurologic investigation was normal, including a transthoracic echocardiography. A 5 x 5 mm pedunculated, mobile mass was described on the intraoperative transesophageal echocardiography. The excision was performed through the left atrial appendage during the coronary artery bypass surgery. The microscopic examination demonstrated a papillary fibroelastoma. The unusual localization and management of papillary fibroelastomas are discussed.
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