Resección conservadora del fibroelastoma papilar: resultados y revisión de la literatura

Abstract

Introduction and objectives

Papillary fibroelastoma is a benign primary cardiac tumor normally located in the valvular endocardium, although it can be found in other endocardial structures. According to recent studies, it could be the most common benign primary cardiac tumor. In a significant number of cases it is asymptomatic, diagnosed incidentally and, in symptomatic cases, usually they present as thromboembolic neurological events. We show our experience in the surgical treatment of papillary fibroelastoma and a review of the literature is performed.

Methods

Single-center retrospective study by reviewing the medical records of all patients diagnosed with papillary fibroelastoma and surgically treated in our department.

Results

From January 2016 to October 2022, 14 patients were operated on, predominantly men, with a mean age of 61 ± 12.6 years. The diagnosis was made mostly in almost all cases during the preoperative study for other indications. Most of the tumors were asymptomatic and were located in the aortic valve. No patient required valve replacement or repair. In 5 cases (35.7%) concomitant cryoablation was performed. There was no surgical mortality. After 3.2 ± 2.22 years of follow-up, two patients died of non-cardiac causes. No tumoral recurrences have been found.

Conclusions

Surgical treatment of papillary fibroelastoma is safe and offers good short and mid-term results. Concomitant cryoablation might be useful to achieve complete tumor removal without the need for valve replacement, however more evidence is mandatory. The realization of a multicenter registry would allow a better knowledge of this tumors.