TRANSIENT LOSS OF VISION AS THE PRESENTING SYMPTOM OF PAPILLARY FIBROELASTOMA OF AORTIC-VALVE

Cardiac papillary fibroelastomas are benign endocardial papillomas. Th ey may arise from atrial or ventricular endocardium but most commonly are located in cardiac valves. Their papillary structure, with loose, friable projections, results in a high tendency for embolism. Turner f ragments often embolize to the coronary, systemic, or cerebral arteria l systems. Thus, acute myocardial infarction, cerebrovascular accident , or peripheral arterial occlusion have resulted from these tumors. Re tinal artery embolism is a rare complication of papillary fibroelastom a, and only five such patients have been reported in the English-langu age literature. We describe a 64-year-old woman who presented with tra nsient painless loss of vision and was found to have a large papillary fibroelastoma on the right coronary cusp of the aortic valve by trans esophageal echocardiography. The tumor was success fully removed at su rgery. (C) 1997 by Elsevier Science Inc.