Resection of Large Aortic Valve Papillary Fibroelastoma

Papillary fibroelastoma is the most common benign tumor of the cardiac valvular apparatus, and is considered the second most common type of cardiac tumor. Advancement in trans-esophageal echocardiography technology has significantly improved the ability of surgeons to spot papillary fibroelastoma, as well as evaluate the structural and functional anatomy of the adjacent heart valves. The tumor is known to be associated with substantial complications that are secondary to systemic embolism. Incidentally discovered tumors are usually treated on the basis of size, mobility, and the patient’s associated comorbidities and symptoms. Surgical resection is usually offered to patients who have symptoms, or to asymptomatic patients who have pedunculated lesions larger than 1 cm in diameter. Valve-sparing excision produces good long-term results.