|A Case of Papillary
Fibroelastoma of the Left Ventricular Septum Complicated with
a Rheumatic Valve
(Department of Cardiovascular Surgery, The Heart
Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan)
|A 50-year-old man was referred to
our hospital with a tumor in the left ventricle. He had suffered
from rheumatic fever when 14 years old. He had shown signs of
chronic heart failure due to atrial fibrillation and rheumatic
valves (ASr, MSr) for 10 years. There was a history of unaccountable
fever and rash, so infective endocarditis was suspected and echocardiography
was performed. It showed a homogeneous mass with a diameter of
approximately 10mm, fixed directly to the left ventricular septum
20mm below the aortic valvular ring. At operation, the tumor
was excised together with endocardium and a part of the muscular
coat. The rheumatic aortic and mitral valves were replaced with
a 21mm SJM AHP and a 27mm SJM MTK mitral valve, respectively.
Tricuspid annuloplasty (TAP) (De Vega 29mm) was also performed.
Histopathological examination of the tumor revealed benign papillary
fibroelastoma. It suggested that the tumors were secondary to
mechanical wear and tear, and represent a degenerative process
due to rheumatic valve disease.
ü@Jpn. J. Cardiovasc. Surg. 29: 33-36 (2000)