Papillary Fibroelastoma in the Left Ventricle Resected Under the Guidance of a Gastrointestinal Fiberscope

Video-assisted endoscopic resection of left ventricular papillary fibroelastoma through the aortic valve

Papillary fibroelastoma is a rare, benign cardiac tumor. Surgical resection is indicated to prevent embolization. We herein report a case of a 78-year-old asymptomatic man who was found to have a mobile left ventricular papillary fibroelastoma anchoring deep in the left ventricle by incidental transthoracic echocardiography. The tumor was resected under visualization by a video-assisted rigid endoscope with a flexible head inserted through the aortic valve into the left ventricle. Intraoperative frozen section analysis provided a pathological diagnosis of papillary fibroelastoma. The postoperative course was uneventful. This technique is recommended for the observation and resection of a tumor anchoring deep in the left ventricle and is helpful for avoiding the adverse effects of left ventriculotomy.

Ventricular mass: a clinical and surgical conundrum

Cardiac tumours are rare in occurrence. The authors report a patient who presented with a history of recurrent transient ischemic attacks and cerebrovascular accidents. During rehabilitation he was incidentally diagnosed with a large left ventricular mass which was excised successfully with good clinical outcome. On histopathology it was a papillary fibroelastoma.

Left ventricular apical lipoma resected under the guidance of a mediastinoscope

We report a 57-year-old man who was found to have a left ventricular apical mass during a routine check-up. He previously had neither any subjective symptom nor hemodynamic problem. The mass was located deeply in the left ventricular cavity. With exploration using a mediastinoscope, we successfully resected the tumor, which was a yellowish lipoid mass that adhered to the trabeculae near the apex. Histopathologic examination of the tumor was consistent with a lipoma, a very rare benign primary cardiac tumor. The mediastinoscope can be useful for surgical resection of tumors located deeply in the left ventricle.