Mitral valve repair for anterior leaflet pupillary fibroelastoma: Two casedescriptions and a literature review

Cardiac papillary fibroelastomas are rare cardiac tumors and have bean cons idered a 'benign' incidental finding that may have significant clinical man ifestations. In this paper we report two cases of mitral valve fibroelastom a: one was discovered by chance with transthoracic echocardiography in a yo ung healthy man, the other was an intraoperative incidental finding in a mi ddle aged man with a recent history of acute myocardial infarction. The mit ral valve was repaired in both cases after excising the tumor. The patients did well and remain asymptomatic. A literature review was compiled which c omprises previous case reports of 34 patients with mitral valve papillary f ibroelastomas. Most were asymptomatic, but when symptoms occurred, they cou ld be disabling, such as stroke, cardiac heart failure, myocardial infarcti on, and sudden death. Papillary fibroelastoma is amenable to simple surgica l excision or in addition to mitral valve repair or replacement. Recurrence has not been reported. (C) 1999 Elsevier Science B.V. All rights reserved.