ABSTRACT
Papillary fibroelastoma is a rare, benign heart tumor. We successfully treated a patient with multiple fibroelastomas derived from both the mitral valve and the chordae by surgical excision. A 59-year-old man was admitted to our hospital with a history of myocardial infarction three years before admission. Preoperative transthoracic and transesophageal echocardiograms showed multiple, mobile, rounded cardiac tumors in the left ventricular cavity and the mitral valve. Under cardiopulmonary bypass, we performed prosthetic mitral valve replacement after excising the valve with the tumor. The patient was discharged and remains asymptomatic. Histologic examination of 6 specimens of the excised tumor confirmed the diagnosis of papillary fibroelastoma. When papillary fibroelastoma is diagnosed, surgical treatment must be considered because of the high risk of embolization.
ABSTRACT
Ebstein's anomaly is a rare congenital heart disease. We treated two patients with this malformation using a new surgical technique proposed by Carpentier. The technique consists of reconstructing the longitudinal plication of the atrialized chamber and repositioning the anterior and posterior leaflets of the tricuspid valve to the true anatomical annulus. The first patient, a 16-year-old boy, underwent surgery on September 5, 1990, and the second patient, a 13-year-old girl, on July 24, 1991. Atrial septal defect was seen only in the second patient, and was closed without a patch. Aortic cross clamping lasted an average of 96 minutes. The surgical technique was relatively easy, and the postoperative course was uneventful in both patients. The cardiothoracic ratio was reduced from 68% to 54% in the first patient and from 64% to 52% in the second. We concluded that Carpentier's operation led to good clinical results for Ebstein's anomaly.