Cardiac fibroelastomas: Six operated cases and a review of the literature.

The authors reviewed the cases of 6 patients operated between September 199 4 and February 1999 for a rare benign tumour: papillary fibroelastoma of th e heart. These patients, aged 51+/-14 years, all have single valvular involvement: m itral (N = 3), aortic (N = 2), tricuspid (N = 1). Five patients were sympto matic: transient ischaemic cerebral events (N = 3) associated with mesenter ic infarction requiring ileal resection in 1 case: constituted cerebrovascu lar accident (N = 1): syncope (N = 1). In this last patient, the fibroelast oma was diagnosed fortuitously on the tricuspid valve. The features and loc ation of the tumours were determined by transcesophageal echocardiography. Surgical treatment in all patients consisted in excising the tumour and pre serving the valve. One aortic cusp was reconstructed after excising the tum our with a cryopreserved partial aortic homograft. Peroperative transcesoph ageal echocardiography confirmed the absence of regurgitation after the pro cedures in all patients. There were no postoperative complications in any o f the cases. No cases of valvular regurgitation or of tumour recurrence wer e observed during follow-up. Despite the benign histology, cardiac fibroelastomas should be excised beca use of their embolic complications. Absence of recurrence justifies conserv ative reconstruction of the affected valve.