Surgical treatment of cardiac papillary fibroelastoma: A single center experience with eighty-eight patients

Dumbor L. Ngaage, Charles J. Mullany, Richard C. Daly, Joseph A. Dearani, William D. Edwards, Henry D. Tazelaar, Christopher G A McGregor, Thomas A. Orszulak, Francisco J. Puga, Hartzell V Schaff, Thoralf M. Sundt, Kenton J. Zehr

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Abstract

Background. Cardiac papillary fibroelastoma is a rare benign tumor that can cause thromboembolism. We have found no large surgical series describing its treatment and outcome. Methods. A retrospective review of all patients treated surgically for this tumor from 1985 to 2002. Results. There were 88 patients with a mean age of 62 ± 16 years. Sixty-two (71%) were male. Cardiac papillary fibroelastoma was a primary indication for surgery in 47 (group 1, 53%) and an incidental finding in 41 (group 2, 47%). The common clinical symptoms were neurologic (group 1) and cardiac (group 2). Cardiac valves were predominantly involved (77%); the aortic valve was the most affected (52%). Other common sites were the left ventricular outflow tract (18%) and anterior mitral leaflet (11%). All heart valves were involved in one patient. Seventy-three patients (83%) had shave excision and 8 (9%) excision with valve repair. Of 5 (6%) valve replacements, 2 were for concurrent degenerative valve disease. Concomitant procedures included repair or replacement of another valve (32 %), CABG (28%), and septal myectomy (19%). Surgical mortality occurred in 1 patient (2.1%) in group 1 who had concomitant lung resection for bronchiolitis obliterans. There was no tumor recurrence, and no tumor-related late morbidity or mortality at a mean follow-up of 3 years. Conclusions. Cardiac papillary fibroelastoma has a propensity to affect the anatomically contiguous structures of the aortic valve, left ventricular outflow tract, and anterior mitral leaflet. Surgical treatment by simple shave excision is low risk and can achieve good results.

Original languageEnglish (US)
Pages (from-to)1712-1718
Number of pages7
JournalAnnals of Thoracic Surgery
Volume80
Issue number5
DOIs
StatePublished - Nov 2005

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Heart Valves
Aortic Valve
Neoplasms
Bronchiolitis Obliterans
Therapeutics
Incidental Findings
Mortality
Thromboembolism
Neurologic Manifestations
Morbidity
Recurrence
Lung

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Ngaage, D. L., Mullany, C. J., Daly, R. C., Dearani, J. A., Edwards, W. D., Tazelaar, H. D., ... Zehr, K. J. (2005). Surgical treatment of cardiac papillary fibroelastoma: A single center experience with eighty-eight patients. Annals of Thoracic Surgery, 80(5), 1712-1718. https://doi.org/10.1016/j.athoracsur.2005.04.030

Surgical treatment of cardiac papillary fibroelastoma : A single center experience with eighty-eight patients. / Ngaage, Dumbor L.; Mullany, Charles J.; Daly, Richard C.; Dearani, Joseph A.; Edwards, William D.; Tazelaar, Henry D.; McGregor, Christopher G A; Orszulak, Thomas A.; Puga, Francisco J.; Schaff, Hartzell V; Sundt, Thoralf M.; Zehr, Kenton J.

In: Annals of Thoracic Surgery, Vol. 80, No. 5, 11.2005, p. 1712-1718.

Research output: Contribution to journalArticle

Ngaage, DL, Mullany, CJ, Daly, RC, Dearani, JA, Edwards, WD, Tazelaar, HD, McGregor, CGA, Orszulak, TA, Puga, FJ, Schaff, HV, Sundt, TM & Zehr, KJ 2005, 'Surgical treatment of cardiac papillary fibroelastoma: A single center experience with eighty-eight patients', Annals of Thoracic Surgery, vol. 80, no. 5, pp. 1712-1718. https://doi.org/10.1016/j.athoracsur.2005.04.030
Ngaage, Dumbor L. ; Mullany, Charles J. ; Daly, Richard C. ; Dearani, Joseph A. ; Edwards, William D. ; Tazelaar, Henry D. ; McGregor, Christopher G A ; Orszulak, Thomas A. ; Puga, Francisco J. ; Schaff, Hartzell V ; Sundt, Thoralf M. ; Zehr, Kenton J. / Surgical treatment of cardiac papillary fibroelastoma : A single center experience with eighty-eight patients. In: Annals of Thoracic Surgery. 2005 ; Vol. 80, No. 5. pp. 1712-1718.
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abstract = "Background. Cardiac papillary fibroelastoma is a rare benign tumor that can cause thromboembolism. We have found no large surgical series describing its treatment and outcome. Methods. A retrospective review of all patients treated surgically for this tumor from 1985 to 2002. Results. There were 88 patients with a mean age of 62 ± 16 years. Sixty-two (71{\%}) were male. Cardiac papillary fibroelastoma was a primary indication for surgery in 47 (group 1, 53{\%}) and an incidental finding in 41 (group 2, 47{\%}). The common clinical symptoms were neurologic (group 1) and cardiac (group 2). Cardiac valves were predominantly involved (77{\%}); the aortic valve was the most affected (52{\%}). Other common sites were the left ventricular outflow tract (18{\%}) and anterior mitral leaflet (11{\%}). All heart valves were involved in one patient. Seventy-three patients (83{\%}) had shave excision and 8 (9{\%}) excision with valve repair. Of 5 (6{\%}) valve replacements, 2 were for concurrent degenerative valve disease. Concomitant procedures included repair or replacement of another valve (32 {\%}), CABG (28{\%}), and septal myectomy (19{\%}). Surgical mortality occurred in 1 patient (2.1{\%}) in group 1 who had concomitant lung resection for bronchiolitis obliterans. There was no tumor recurrence, and no tumor-related late morbidity or mortality at a mean follow-up of 3 years. Conclusions. Cardiac papillary fibroelastoma has a propensity to affect the anatomically contiguous structures of the aortic valve, left ventricular outflow tract, and anterior mitral leaflet. Surgical treatment by simple shave excision is low risk and can achieve good results.",
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T1 - Surgical treatment of cardiac papillary fibroelastoma

T2 - A single center experience with eighty-eight patients

AU - Ngaage, Dumbor L.

AU - Mullany, Charles J.

AU - Daly, Richard C.

AU - Dearani, Joseph A.

AU - Edwards, William D.

AU - Tazelaar, Henry D.

AU - McGregor, Christopher G A

AU - Orszulak, Thomas A.

AU - Puga, Francisco J.

AU - Schaff, Hartzell V

AU - Sundt, Thoralf M.

AU - Zehr, Kenton J.

PY - 2005/11

Y1 - 2005/11

N2 - Background. Cardiac papillary fibroelastoma is a rare benign tumor that can cause thromboembolism. We have found no large surgical series describing its treatment and outcome. Methods. A retrospective review of all patients treated surgically for this tumor from 1985 to 2002. Results. There were 88 patients with a mean age of 62 ± 16 years. Sixty-two (71%) were male. Cardiac papillary fibroelastoma was a primary indication for surgery in 47 (group 1, 53%) and an incidental finding in 41 (group 2, 47%). The common clinical symptoms were neurologic (group 1) and cardiac (group 2). Cardiac valves were predominantly involved (77%); the aortic valve was the most affected (52%). Other common sites were the left ventricular outflow tract (18%) and anterior mitral leaflet (11%). All heart valves were involved in one patient. Seventy-three patients (83%) had shave excision and 8 (9%) excision with valve repair. Of 5 (6%) valve replacements, 2 were for concurrent degenerative valve disease. Concomitant procedures included repair or replacement of another valve (32 %), CABG (28%), and septal myectomy (19%). Surgical mortality occurred in 1 patient (2.1%) in group 1 who had concomitant lung resection for bronchiolitis obliterans. There was no tumor recurrence, and no tumor-related late morbidity or mortality at a mean follow-up of 3 years. Conclusions. Cardiac papillary fibroelastoma has a propensity to affect the anatomically contiguous structures of the aortic valve, left ventricular outflow tract, and anterior mitral leaflet. Surgical treatment by simple shave excision is low risk and can achieve good results.

AB - Background. Cardiac papillary fibroelastoma is a rare benign tumor that can cause thromboembolism. We have found no large surgical series describing its treatment and outcome. Methods. A retrospective review of all patients treated surgically for this tumor from 1985 to 2002. Results. There were 88 patients with a mean age of 62 ± 16 years. Sixty-two (71%) were male. Cardiac papillary fibroelastoma was a primary indication for surgery in 47 (group 1, 53%) and an incidental finding in 41 (group 2, 47%). The common clinical symptoms were neurologic (group 1) and cardiac (group 2). Cardiac valves were predominantly involved (77%); the aortic valve was the most affected (52%). Other common sites were the left ventricular outflow tract (18%) and anterior mitral leaflet (11%). All heart valves were involved in one patient. Seventy-three patients (83%) had shave excision and 8 (9%) excision with valve repair. Of 5 (6%) valve replacements, 2 were for concurrent degenerative valve disease. Concomitant procedures included repair or replacement of another valve (32 %), CABG (28%), and septal myectomy (19%). Surgical mortality occurred in 1 patient (2.1%) in group 1 who had concomitant lung resection for bronchiolitis obliterans. There was no tumor recurrence, and no tumor-related late morbidity or mortality at a mean follow-up of 3 years. Conclusions. Cardiac papillary fibroelastoma has a propensity to affect the anatomically contiguous structures of the aortic valve, left ventricular outflow tract, and anterior mitral leaflet. Surgical treatment by simple shave excision is low risk and can achieve good results.

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