Di Marco Luca, Al-Basheer Amin, Glineur David, Oppido Guido, Di Bartolomeo Roberto, El-Khoury Gebrine
Cliniques Universitaires St Luc, Service de Chirurgie Cardiovasculaire et Thoracique, Brussels, Belgium.
J Cardiovasc Med (Hagerstown). 2006 May;7(5):362-4. doi: 10.2459/01.JCM.0000223260.54803.b2.
We report the case of aortic valve-papillary fibroelastoma in a 66-year-old Belgian woman with a previous single episode of cerebral transient ischemic attack. Transthoracic two-dimensional echocardiography revealed a small mass adherent to the noncoronary cusp of the valve, which was confirmed by transesophageal echocardiography. Indication for surgery was performed because of a previous cerebral transient ischemic attack and for its potential risk of cerebral and coronary embolization. Surgical excision of the mass was performed with the need for glutaraldehyde-treated autologous pericardial patch repair of the aortic cusp. Intraoperative and postoperative transesophageal echocardiography both showed the valve to be competent. Postoperative recovery was uneventful. After a review of the literature, we conclude that, even if asymptomatic, and independent of their size, aortic valve papillary fibroelastomas justify surgical excision for their potential to systemic embolization. Moreover, we believe that a valve-sparing approach might be feasible with no recurrence after complete excision.
我们报告了一例66岁比利时女性的主动脉瓣乳头肌纤维弹性瘤病例，该女性曾有过一次短暂性脑缺血发作。经胸二维超声心动图显示一个小肿块附着在瓣膜的无冠瓣叶上，经食管超声心动图证实了这一点。由于既往有短暂性脑缺血发作以及存在脑和冠状动脉栓塞的潜在风险，因此进行了手术指征评估。对肿块进行了手术切除，同时需要用戊二醛处理的自体心包补片修复主动脉瓣叶。术中及术后经食管超声心动图均显示瓣膜功能正常。术后恢复顺利。在查阅文献后，我们得出结论，即使无症状，且无论大小，主动脉瓣乳头肌纤维弹性瘤因其有发生全身栓塞的可能性，均需进行手术切除。此外，我们认为保留瓣膜的手术方法可能可行，完全切除后无复发。
