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Ann Thorac Surg 1996;61:1041-1042
© 1996 The Society of Thoracic Surgeons

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Correspondence

Primary Cardiac Valve Tumors

Division of Cardiac-Thoracic Surgery, Saint Vincent Hospital, 25 Winthrop St, Worcester, Ma 01604-4593

To the Editor:

In less than 1 year at least four articles relating to valve tumors have appeared in The Annals [1–4]. Since a comprehensive review in 1991 [5], others have documented their experience [6–8]. The majority are case reports with individualized approaches. Shahian and associates' [2] in-depth current review highlights the increased incidence probably related to improved noninvasive imaging modalities. Treatment ranges from excision to repair to valve replacement. Among the 46 references cited, little long-term information is available. Dralle and colleagues [1] reported excision of a tricuspid chondroma with less than 2-year follow-up. Kennedy and co-workers [3] performed excision and replacement of an aortic valve myxoma. Eckstein and associates [4] performed excision and reconstruction of an aortic valve papillary fibroelastoma. All these methods warrant consideration and long-term follow-up. The natural history of asymptomatic primary cardiac valve tumors remains unknown. Operative treatment mandates long-term follow-up. The recent report by Brown and colleagues [8] summarized 14 patients with left-sided papillary fibroelastomas. Three had cerebral ischemic events. A strong case is made for operative intervention in all patients with documented left-sided lesions. Additionally, primary left-sided valve tumors should be strongly considered in the differential diagnosis of ischemic cerebral events. Primary cardiac valve tumors deserve increased appreciation with a plea for long-term evaluation and reporting.

References

1. Dralle JG, Dinesh J, Ponnambalam S, Replogle RL. Cardiac valvular chondroma. Ann Thorac Surg 1994;58:1540–2.[Abstract]
2. Shahian DM, Labib SB, Chang G. Cardiac papillary fibroelastoma. Ann Thorac Surg 1995;59:538–41.[Abstract/Free Full Text]
3. Kennedy P, Parry AJ, Dinah P, Pillai R. Myxoma of the aortic valve. Ann Thorac Surg 1995;59:1221–3.[Abstract/Free Full Text]
4. Eckstein FS, Schafers HJ, Grote J, Mugge A, Borst HG. Papillary fibroelastoma of the aortic valve presenting with myocardial infarction. Ann Thorac Surg 1995;60:206–8.[Abstract/Free Full Text]
5. Edwards FH, Hale D, Cohen A, Thompson L, Pezzella AT, Virmani R. Primary cardiac valve tumors. Ann Thorac Surg 1991;52:1127–37.[Abstract]
6. Kuroda H, Nitta K, Ashida Y, Hara Y, Ishiguro S, Mori T. Right atrial myxoma originating from the tricuspid valve. J Thorac Cardiovasc Surg 1995;109:1249–50.[Free Full Text]
7. Lee CC, Cazibe C, Lajos TZ. Excision of papillary fibroelastoma arising from the septal leaflet of tricuspid valve. J Card Surg 1995;10:589–91.[Medline]
8. Brown RD, Khandheria BK, Edwards WD. Cardiac papillary fibroelastoma: a treatable cause of transient ischemia attack and ischemic stroke detected by transesophageal echocardiography. Mayo Clinic Proc 1995;70:863–8.[Abstract]

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): A. Thomas Pezzella Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pezzella, A. T. Search for Related Content PubMed PubMed Citation Articles by Pezzella, A. T.