Left ventricular papillary fibroelastomas without relation to a heart valve - a report of 2 cases

Papillary fibroelastomas are rare benign tumors of the heart. We report abo ut two cases in which these tumors do not - as characteristically arise fro m a heart valve but originate from the free wall of the left ventricle. In the case of a 74-year-old woman with signs of a cerebral ischemia in the va scular system of the A. cerebri posterior, the tumor was resected transaort ically. At a 67-year-old patient with symptoms of instable angina pectoris and increasing dyspnoea echocardiography or coronary angiography showed an aortic stenosis III degrees, a coronary artery disease as well as a tumor w ithin the region of the apex of the left ventricle. Beside a fourfold aorto coronary venous bypass and an aortic valve replacement tumor excision via l eft ventriculotomy was carried out. In the diagnostics of intracardiac tumo rs transthoracic and transesophageal echocardiography provide the methods o f choice to visualize quickly and noninvasively the extent, mobility, and o rigin of the tumor. Considering the systemic thromboembolic potential with the high risk of cerebrovascular respectively neurological symptoms total s urgical tumor excision is clearly indicated.