Mohammadi Siamak, Martineau Andre, Voisine Pierre, Dagenais François
Department of Cardiac Surgery, Laval Hospital, Québec City, Québec, Canada.
Ann Thorac Surg. 2007 Oct;84(4):1396-7. doi: 10.1016/j.athoracsur.2007.05.057.
Papillary fibroelastomas have been increasingly described since the widespread use of cardiac echocardiography. Most often diagnosed incidentally, papillary fibroelastomas may embolize, mainly to the cerebral circulation. The aortic valve is predominantly affected. The left ventricle is the most frequent nonvalvular location. We present a case of a 59-year-old man who had recurrent episodes of cerebral ischemic attacks and required coronary artery bypass surgery. The overall neurologic investigation was normal, including a transthoracic echocardiography. A 5 x 5 mm pedunculated, mobile mass was described on the intraoperative transesophageal echocardiography. The excision was performed through the left atrial appendage during the coronary artery bypass surgery. The microscopic examination demonstrated a papillary fibroelastoma. The unusual localization and management of papillary fibroelastomas are discussed.
自从心脏超声心动图广泛应用以来，乳头状纤维弹性瘤的报道日益增多。乳头状纤维弹性瘤大多是偶然诊断出来的，可能会发生栓塞，主要栓塞到脑循环。主动脉瓣是最常受累的部位。左心室是最常见的非瓣膜部位。我们报告一例59岁男性患者，该患者反复发生脑缺血发作，需要进行冠状动脉搭桥手术。包括经胸超声心动图在内的全面神经系统检查均正常。术中经食管超声心动图显示一个5×5毫米带蒂的可移动肿物。在冠状动脉搭桥手术期间，通过左心耳进行了切除。显微镜检查显示为乳头状纤维弹性瘤。本文讨论了乳头状纤维弹性瘤不寻常的定位和处理方法。
