Prognostic and bioepidemiologic implications of papillary fibroelastomas

Syahidah S. Tamin, Joseph Maleszewski, Christopher G. Scott, S. K. Khan, William D. Edwards, Charles J Bruce, Jae Kuen Oh, Patricia Pellikka, Kyle W. Klarich

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background Papillary fibroelastomas (PFE) are benign neoplasms with little available outcome data. Objectives This study sought to describe the frequency and clinical course of patients with surgically removed PFE and echocardiographically suspected, but unoperated, PFE. Methods Mayo Clinic pathology and echocardiography databases (January 1, 1995, to December 31, 2010) were queried, resulting in 511 patients: group 1 (n = 185), including patients with surgically removed, histopathologically confirmed PFE; group 1a (n = 94; 51%) with PFE removed at primary surgery; and group 1b (n = 91; 49%) with PFE removal at time of another cardiac surgery. Group 2 (n = 326) patients had echocardiographic evidence of PFE but no cardiac surgery to remove PFE. Results Group 1 had mean age of 63 ± 14 years (116 women [63%]). During the study period, we identified 112 cardiac myxomas in the pathology database and 142 in the echocardiographic database. Mean age in group 2 was 67 ± 14 years (162 women [50%]). PFE occurred most commonly on cardiac valves (n = 400 [78%]). In group 1, transient ischemic attack or stroke was the presenting symptom in 58 patients (32%). With surgical removal of valvular PFE, the valve was preserved in 92 (98%). Recurrence was documented in 3 patients (1.6%). Follow-up stroke risk in groups 1, 1a, and 1b at 1 year was 2%, 0%, and 4%; at 5 years, 8%, 5%, and 11%, respectively. Cerebrovascular accident risk in group 2 at 1 and 5 years was 6% and 13%. Conclusions In patients with echocardiographically suspected PFE who do not undergo surgical removal, rates of cerebrovascular accident and mortality are increased.

Original languageEnglish (US)
Pages (from-to)2420-2429
Number of pages10
JournalJournal of the American College of Cardiology
Volume65
Issue number22
DOIs
StatePublished - Jun 9 2015

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Stroke
Databases
Thoracic Surgery
Pathology
Myxoma
Transient Ischemic Attack
Heart Valves
Echocardiography
Age Groups
Recurrence
Mortality
Neoplasms

Keywords

  • cardiac tumor
  • neoplasm
  • source of embolism
  • valve mass

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic and bioepidemiologic implications of papillary fibroelastomas. / Tamin, Syahidah S.; Maleszewski, Joseph; Scott, Christopher G.; Khan, S. K.; Edwards, William D.; Bruce, Charles J; Oh, Jae Kuen; Pellikka, Patricia; Klarich, Kyle W.

In: Journal of the American College of Cardiology, Vol. 65, No. 22, 09.06.2015, p. 2420-2429.

Research output: Contribution to journalArticle

Tamin, Syahidah S. ; Maleszewski, Joseph ; Scott, Christopher G. ; Khan, S. K. ; Edwards, William D. ; Bruce, Charles J ; Oh, Jae Kuen ; Pellikka, Patricia ; Klarich, Kyle W. / Prognostic and bioepidemiologic implications of papillary fibroelastomas. In: Journal of the American College of Cardiology. 2015 ; Vol. 65, No. 22. pp. 2420-2429.
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title = "Prognostic and bioepidemiologic implications of papillary fibroelastomas",
abstract = "Background Papillary fibroelastomas (PFE) are benign neoplasms with little available outcome data. Objectives This study sought to describe the frequency and clinical course of patients with surgically removed PFE and echocardiographically suspected, but unoperated, PFE. Methods Mayo Clinic pathology and echocardiography databases (January 1, 1995, to December 31, 2010) were queried, resulting in 511 patients: group 1 (n = 185), including patients with surgically removed, histopathologically confirmed PFE; group 1a (n = 94; 51{\%}) with PFE removed at primary surgery; and group 1b (n = 91; 49{\%}) with PFE removal at time of another cardiac surgery. Group 2 (n = 326) patients had echocardiographic evidence of PFE but no cardiac surgery to remove PFE. Results Group 1 had mean age of 63 ± 14 years (116 women [63{\%}]). During the study period, we identified 112 cardiac myxomas in the pathology database and 142 in the echocardiographic database. Mean age in group 2 was 67 ± 14 years (162 women [50{\%}]). PFE occurred most commonly on cardiac valves (n = 400 [78{\%}]). In group 1, transient ischemic attack or stroke was the presenting symptom in 58 patients (32{\%}). With surgical removal of valvular PFE, the valve was preserved in 92 (98{\%}). Recurrence was documented in 3 patients (1.6{\%}). Follow-up stroke risk in groups 1, 1a, and 1b at 1 year was 2{\%}, 0{\%}, and 4{\%}; at 5 years, 8{\%}, 5{\%}, and 11{\%}, respectively. Cerebrovascular accident risk in group 2 at 1 and 5 years was 6{\%} and 13{\%}. Conclusions In patients with echocardiographically suspected PFE who do not undergo surgical removal, rates of cerebrovascular accident and mortality are increased.",
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T1 - Prognostic and bioepidemiologic implications of papillary fibroelastomas

AU - Tamin, Syahidah S.

AU - Maleszewski, Joseph

AU - Scott, Christopher G.

AU - Khan, S. K.

AU - Edwards, William D.

AU - Bruce, Charles J

AU - Oh, Jae Kuen

AU - Pellikka, Patricia

AU - Klarich, Kyle W.

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N2 - Background Papillary fibroelastomas (PFE) are benign neoplasms with little available outcome data. Objectives This study sought to describe the frequency and clinical course of patients with surgically removed PFE and echocardiographically suspected, but unoperated, PFE. Methods Mayo Clinic pathology and echocardiography databases (January 1, 1995, to December 31, 2010) were queried, resulting in 511 patients: group 1 (n = 185), including patients with surgically removed, histopathologically confirmed PFE; group 1a (n = 94; 51%) with PFE removed at primary surgery; and group 1b (n = 91; 49%) with PFE removal at time of another cardiac surgery. Group 2 (n = 326) patients had echocardiographic evidence of PFE but no cardiac surgery to remove PFE. Results Group 1 had mean age of 63 ± 14 years (116 women [63%]). During the study period, we identified 112 cardiac myxomas in the pathology database and 142 in the echocardiographic database. Mean age in group 2 was 67 ± 14 years (162 women [50%]). PFE occurred most commonly on cardiac valves (n = 400 [78%]). In group 1, transient ischemic attack or stroke was the presenting symptom in 58 patients (32%). With surgical removal of valvular PFE, the valve was preserved in 92 (98%). Recurrence was documented in 3 patients (1.6%). Follow-up stroke risk in groups 1, 1a, and 1b at 1 year was 2%, 0%, and 4%; at 5 years, 8%, 5%, and 11%, respectively. Cerebrovascular accident risk in group 2 at 1 and 5 years was 6% and 13%. Conclusions In patients with echocardiographically suspected PFE who do not undergo surgical removal, rates of cerebrovascular accident and mortality are increased.

AB - Background Papillary fibroelastomas (PFE) are benign neoplasms with little available outcome data. Objectives This study sought to describe the frequency and clinical course of patients with surgically removed PFE and echocardiographically suspected, but unoperated, PFE. Methods Mayo Clinic pathology and echocardiography databases (January 1, 1995, to December 31, 2010) were queried, resulting in 511 patients: group 1 (n = 185), including patients with surgically removed, histopathologically confirmed PFE; group 1a (n = 94; 51%) with PFE removed at primary surgery; and group 1b (n = 91; 49%) with PFE removal at time of another cardiac surgery. Group 2 (n = 326) patients had echocardiographic evidence of PFE but no cardiac surgery to remove PFE. Results Group 1 had mean age of 63 ± 14 years (116 women [63%]). During the study period, we identified 112 cardiac myxomas in the pathology database and 142 in the echocardiographic database. Mean age in group 2 was 67 ± 14 years (162 women [50%]). PFE occurred most commonly on cardiac valves (n = 400 [78%]). In group 1, transient ischemic attack or stroke was the presenting symptom in 58 patients (32%). With surgical removal of valvular PFE, the valve was preserved in 92 (98%). Recurrence was documented in 3 patients (1.6%). Follow-up stroke risk in groups 1, 1a, and 1b at 1 year was 2%, 0%, and 4%; at 5 years, 8%, 5%, and 11%, respectively. Cerebrovascular accident risk in group 2 at 1 and 5 years was 6% and 13%. Conclusions In patients with echocardiographically suspected PFE who do not undergo surgical removal, rates of cerebrovascular accident and mortality are increased.

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KW - neoplasm

KW - source of embolism

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