Papillary fibroelastoma of the left ventricle combined with coronary artery disease: A case study

Nguyen Ngoc Trung , Nguyen Truong Giang , Vu Duc Thang , Pham Vu Thu Ha , Tran Dac Tiep , Nguyen Chi Tue , Le Ba Hanh , Nguyen The Kien

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Abstract

Primary heart tumor is a very rare disease, accounting for about 0.0017 - 0.28% of all tumors. In particular, papillary fibroelasroma (PFE) combined with coronary disease (CAD)is extremely rare. We report a case of PFE of the left ventricle combined coronary artery disease. A 67- year-old woman who was admitted for chest pain and her subsequent transthoracic and transesophageal echocardiography showed a mass of myocardial density, high mobility, measuring 14x18mm in the left ventricle, attached to the anterolateral papillary muscle. Other findings were mild mitral and tricuspid regurgitation, no pulmonary hypertension, and normal left ventricular systolic function. Coronary angiography showed stenosis of the left main (40%), and significant stenosis of the left anterior descending artery (LAD) (80%), left circumflex artery (LCx) (90%) and right coronary artery (RCA) (80%). The patient underwent a median sternotomy with cardiopulmonary bypass. The tumor was removed via the mitral valve and coronary artery bypass grafting to the LAD, LCx and RCA was performed using the left internal thoracic artery and saphenous vein grafts. The histopathology and immunohistochemistry analysis of the sample confirmed the diagnosis of PFE. Postoperative follow-up showed no sign of recurrence up to 4 months.

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References

[1] H. Xu, L. Chen, C. Ye et al., “Cardiac Papillary Fibroelastoma with Coronary Artery Anomaly: A Case Report,” Heart Surg Forum, vol. 20, no. 2, pp. E052-E054, Apr 28, 2017.
[2] P. L. Chia, “Incidental finding of an aortic valve mass on 64-slice computed tomographic coronary angiography,” Ann Acad Med Singapore, vol. 38, no. 10, pp. 926-7, Oct, 2009.
[3] S. Arai, D. Tanaka, M. Sakuma et al., “[Papillary Fibroelastoma of the Left Ventricular Outflow Tract; Report of a Case],” Kyobu Geka, vol. 71, no. 9, pp. 697-700, Sep, 2018.
[4] S. Page, R. Grant, and A. Iyer, “Cardiac papillary fibroelastoma originating from the left ventricular septum,” J Card Surg, vol. 33, no. 4, pp. 181-182, Apr, 2018.
[5] Y. Tanaka, T. Kitamura, K. Kobayashi et al., “Papillary fibroelastoma of the left ventricular apex excised using a videoscopic technique,” J Card Surg, vol. 33, no. 5, pp. 277-
279, May, 2018.
[6] J. M. Grinda, J. P. Couetil, S. Chauvaud et al., “Cardiac valve papillary fibroelastoma: surgical excision for revealed or potential embolization,” J Thorac Cardiovasc Surg, vol. 117, no. 1, pp. 106-10, Jan, 1999.
[7] H. Kurobe, T. Kanbara, H. Yoshida et al., “Successful early resection of cardiac papillary fibroelastomas,” Gen Thorac Cardiovasc Surg, vol.
59, no. 3, pp. 191-4, Mar, 2011.
[8] D. L. Ngaage, C. J. Mullany, R. C. Daly et al., “Surgical treatment of cardiac papillary fibroelastoma: a single center experience with eighty-eight patients,” Ann Thorac Surg, vol. 80, no. 5, pp. 1712-8, Nov, 2005.
[9] K. Ishida, H. Satokawa, S. Takase et al., “Video-assisted endoscopic resection of left ventricular papillary fibroelastoma through the aortic valve,” Asian J Endosc Surg, vol. 9, no. 4, pp. 325-327, Nov, 2016.
[10] H. Hakeem, M. Argenziano, and D. Katechis, “A Left Ventricular Papillary Fibroelastoma Presenting as an Acute Coronary Syndrome,” CASE (Phila), vol. 2, no. 1, pp. 24-
26, Feb, 2018.