[The surgical treatment of endomyocardial fibrosis of the left ventricle--the first surgical case report in Japan].

A 66-year-old man with an ECG finding of an elevation of R in leads V5-6 and a calcified space occupying lesion in the apex of the left ventricle on echocardiography admitted for the evaluation of recent onset of shortness of breath and palpitation on exertion. Cineangiography showed an obliteration and accumulation of RI activity in the apex of the left ventricle on TI-201 scintigraphy and a neoplasm of the heart was suspected. Resection of a tumor from apical incision followed by the left atrial approach necessitated the replacement of mitral valve and confirmed the diagnosis of endomyocardial fibrosis. Heart failure persisted and the expired 2 years after surgery due to the gastrointestinal infection. An experience suggested the resection of a mass from the left atrial approach is possible and recommended to prevent the occurrence and persistence of heart failure in case the diagnosis is established preoperatively.