Papillary fibroelastoma of the mitral valve 12 years after mitral valve commissurotomy

A 63-year-old woman who had had mitral valve commissurotomy 12 years earlie r was seen because of rheumatic mitral stenosis and left brachial-paresis d ue to cerebral embolism,On clinical evaluation, a diastolic rumble was hear d over the mitral area, and the echocardiogram revealed a mass attached to the mitral subvalvular apparatus. The patient was operated on, and both the surgical and histologic findings depicted papillary fibroelastoma, This tu mor may occur as an isolated lesion or be associated with mitral valve sten osis or other cardiac abnormalities, and it is an important source of embol i. Early echocardiographic diagnosis, followed by surgical excision, may av oid serious complications such as stroke, myocardial infarction, and sudden death.