Papillary fibroelastoma as a cause of myocardial ischemia: clinical case
https://doi.org/10.24884/1682-6655-2024-23-1-70-75
Abstract
Papillary fibroelastomas are the most common tumors of the heart valves. Among all primary heart tumors, the incidence of papillary fibroelastoma is about 15 %. The clinical picture is often asymptomatic, however, it can be complicated by a transient ischemic attack, acute cerebrovascular accident, acute myocardial infarction, heart failure, pulmonary embolism, and etc. The article presents a clinical case of a 55-year-old female patient with papillary fibroelastoma of the aortic valve, which caused angina attacks and was a probable cause of several myocardial infarctions. Complex radiation diagnostics using aortic computed tomography with ECG synchronization, transthoracic and transesophageal echocardiography made it possible to visualize a formation in the commissure area between the right coronary and non-coronary aortic valve flaps as the cause of the patient’s clinical manifestations. Comprehensive diagnostics made it possible to successfully perform emergency surgical treatment.
About the Authors
L. E. Galyautdinova
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Galyautdinova Lina E. – Radiologist, Postgraduate Student, Radiology and Medical Visualization Department
2, Akkuratova str., Saint Petersburg, 197341
I. V. Basek
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Basek Ilona V. – Candidate of Medical Sciences (PhD), Docent, Head, Department of Radiology
2, Akkuratova str., Saint Petersburg, 197341
D. V. Alekseeva
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Alekseeva Daria V. – Head, Radiation Diagnostics Department № 1
2, Akkuratova str., Saint Petersburg, 197341
V. M. Vetra
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Vetra Viсtoria M. – Radiologist
2, Akkuratova str., Saint Petersburg, 197341
L. B. Mitrofanova
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Mitrofanova Lyubov’ B. – MD, Docent, Head, Department of Pathomorphology
2, Akkuratova str., Saint Petersburg, 197341
D. V. Bendov
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Bendov Dmitry V. – Candidate of Medical Sciences (PhD), Cardiovascular Surgeon
2, Akkuratova str., Saint Petersburg, 197341
E. L. Urumova
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Urumova Ekaterina L. – Junior Researcher, Functional Diagnostician
2, Akkuratova str., Saint Petersburg, 197341
G. E. Trufanov
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Trufanov Gennady E. – MD, Professor, Head, Radiology and Medical Visualization Department
2, Akkuratova str., Saint Petersburg, 197341
A. S. Sidorina
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Sidorina Anastasia S. – Resident, Radiology and Medical Visualization Department
2, Akkuratova str., Saint Petersburg, 197341
References
1. Nepitella AA, Cadeddu C, Maiani S, Mandas M, Marchetti MF, Montisci R. Papillary fibroelastoma of the aortic valve associated with myocardial infarction, complicated by electrical storm and endoventricular thrombosis. Eur Heart J Suppl. 2022;24(Suppl K). Doi: 10.1093/eurheartjsupp/suac121.567.
2. Ikegami H, Andrei AC, Li Z, McCarthy PM, Malaisrie SC. Papillary fibroelastoma of the aortic valve: analysis of 21 cases, including a presentation with cardiac arrest. Tex Heart Inst J. 2015;42(2):131-135. Doi: 10.14503/THIJ-14-4262.
3. Gowda RM, Khan IA, Nair CK, Mehta NJ, Vasavada BC, Sacchi TJ. Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases. Am Heart J. 2003;146(3):404-410. Doi: 10.1016/S0002-8703(03)00249-7.
4. de la Fuente J, Wang Y, Tan N, Kandlakunta H, Tse CS, Click RL. Cardiac Masses (from a 15-Year Experience With 389 Surgical Cases). Am J Cardiol. 2022;185:100-106. Doi: 10.1016/j.amjcard.2022.09.013.
5. Cianciulli TF, Soumoulou JB, Lax JA et al. Papillary fibroelastoma: clinical and echocardiographic features and initial approach in 54 cases. Echocardiography. 2016; 33(12):1811-1817. Doi: 10.1111/echo.13351.
6. Антонов И.М., Ишевский А.Г., Квитивадзе Н.Г. и др. Острый инфаркт миокарда II типа как следствие фиброэластомы аортального клапана // Лечебное дело. – 2017. – № 3. – С. 100–104. [Antonov IM, Ishevskiy AG, Kvitivadze NG, Antonova LN, Muratov MR, Sorkomov MN, Stryuk RI. Type 2 Myocardial Infarction due to Aortic Valve Fibroelastoma. Lechebnoye delo. 2017; (3):100-104. (In Russ.)].
7. Приходько В.П., Миронов В.А, Нуждин М.Д. Случай папиллярной фиброэластомы с частичной окклюзией устья левой коронарной артерии // Патол. кровообр. и кардиохир. – – 2011. – № 1. – С. 97–99. [Prikhodko VP, Mironov VA, Nuzhdin MD. The case of papillary fibroelastomy with partial occlusion of the mouth of the left coronary artery. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2011;(1):97-99. (In Russ.)].
8. Базылев В.В., Карпухин В.Г., Палькова В.А. и др. Клиническое наблюдение двух случаев папиллярной фиброэластомы сердца: аортального клапана и клапана легочной артерии // Мед. визуализ. – 2016. – № 6. – С. 118– 124. [Bazylev VV, Karpukhin VG, Palkova VA, Evtushkin IA, Simonova OI. Clinical Two Cases of Papillary Fibroelastomy Heart: Aortic Valve and the Pulmonary Artery. Med Visualiz. 2016;(6):118-124. (In Russ.)].
9. Aquino-Bruno H, Andrade-Cuellar EN, Meléndez-Ramírez G, Roque-Palacios CJ, Morales-Portano JD, Flores-Puente F. Myocardial Infarction Due to Nonvalvular Papillary Fibroelastoma of the Left Coronary Sinus: The Importance of Multimodal Imaging. CJC Open. 2022;5(2):158-160. Doi: 10.1016/j.cjco.2022.08.004.
10. Abbas, Anas Mohmoud; BinBrek, Azan Salem; Benny, Sam Codampallil; Al-Assaf, Omar Yousef. Balloon Angioplasty Treatment in Inferior Acute Coronary Syndrome Secondary to Undiagnosed Papillary Fibroelastoma. Hamdan Med J. 2020; 13(3):169-171. Doi: 10.4103/HMJ.HMJ_6_20.
11. Chau ATN, Nguyen QH, Pham HN et al. Cardiac papillary fibroelastoma as a cause of acute coronary syndrome. J Cardiol Cases. 2022;26(5):379-382. Doi: 10.1016/j.jccase. 2022.08.002/.
12. Taha ME, Kumaresan J. Aortic Valve Papillary Fibroelastoma: A Sea Anemone in the Heart, A Case Report. Cardiol Res. 2019;10(6):378-381. Doi: 10.14740/cr818.
13. Tadic S, Ilic A, Stefanovic M et al. Case Report: Multimodality Imaging as a Lifeline for Fatal Localization of Valsalva Sinus Fibroelastoma. Front Cardiovasc Med. 2021; 8:683534. Doi: 10.3389/fcvm.2021.683534.
14. Zoltowska DM, Sadic E, Becoats K, Ghetiya S, Ali AA, Sattiraju S, Missov E. Cardiac papillary fibroelastoma. J Geriatr Cardiol. 2021;18(5):346-351. Doi: 10.11909/j.issn.1671-5411.2021.05.009.
15. Lin Y, Wu W, Gao L, Ji M, Xie M, Li Y. Multimodality Imaging of Benign Primary Cardiac Tumor. Diagnostics (Basel). 2022;12(10):2543. Doi: 10.3390/diagnostics12102543.
Review
For citations:
Galyautdinova L.E., Basek I.V., Alekseeva D.V., Vetra V.M., Mitrofanova L.B., Bendov D.V., Urumova E.L., Trufanov G.E., Sidorina A.S. Papillary fibroelastoma as a cause of myocardial ischemia: clinical case. Regional blood circulation and microcirculation. 2024;23(1):70-75. (In Russ.) https://doi.org/10.24884/1682-6655-2024-23-1-70-75
Views:
384
Email this article 
