Ann Thorac Surg 2006;82:381
© 2006 The Society of Thoracic Surgeons
Correspondence
Cardiac Papillary Fibroelastoma
Yoshio Misawa, MD,
Yuichiro Kaminishi, MD,
Masanobu Taguchi, MD
Division of Cardiovascular Surgery, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, Tochigi, 329-0498, Japan
(Email: tcvmisa{at}jichi.ac.jp).
To the Editor:
We read with great interest Ngaage and colleagues' [1] article in which they analyzed 88 patients with cardiac papillary fibroelastoma. The single center study consisted of a large number of patients with papillary fibroelastoma; therefore, clinical features of the fibroelastoma such as affected sites can be seen as significant and reliable. In the study the authors mentioned that cardiac valves are predominantly involved (77%), followed by the left ventricular outflow tract (18%).
We recently experienced two cases of cardiac papillary fibroelastoma [2]. A 61-year-old man was admitted for resection of a tumor in the left atrium that was incidentally found on follow-up echocardiographic study for hypertension. The tumor was located at the atrial septum without disturbing mitral valve motion. Also, on preoperative studies a 60-year-old woman with ventricular septal defect was found to have a tumor in her right ventricle. The tumor was located at the mid-portion of the right ventricle. Neither patient revealed any singes or symptoms related to the tumors per se. The patients underwent tumor resection without complications. Postoperative pathologic study showed papillary fibroelastomas.
When cardiac tumors involve valves or the ventricular outflow tract, more clinical symptoms may occur than with other cardiac chambers. Ngaage and colleagues [1] mentioned that papillary fibroelastomas were incidental findings in 41 of their 88 patients. However, where are these cases predominantly affected? Clinically silent papillary fibroelastoma may be situated in the cardiac chambers, not disturbing valve function or blood flow at the outflow tract. The analysis of the 41 patients with incidental findings of Ngaage and colleagues' [1] will contribute to our better understanding of the clinical features of cardiac papillary fibroelastomas.
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References
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- Ngaage DL, Mullany CJ, Daly RC, et al. Surgical treatment of cardiac papillary fibroelastomaa single center experience with eighty-eight patients. Ann Thorac Surg 2005;80:1712-1718.[Abstract/Free Full Text]
- Taguchi M, Kaminishi Y, Konishi H, et al. Cardiac fibroelastomas in two adults Kyobu Geka 2005;58:1163-1165.[Medline]
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