A Case of Latent Multiple Papillary Fibroelastomas on the Aortic Valve / 日本心臓血管外科学会雑誌

A 70-year-old female with a pulmonary embolism was admitted to a local hospital. On admission, transthoracic echocardiography detected a mobile cardiac tumor on the aortic valve. After medical treatment for a pulmonary embolism, she was slated for a resection of the tumor in our hospital. Although preoperative examinations showed an isolated tumor attached to the non-coronary cusp without valve dysfunction, meticulous intraoperative inspection revealed multiple fine villous tumors located in the left coronary cusp of the aortic valve. Being immersed in saline solution, these tumors had resembled a distinctive sea anemone-like appearance. These fine tumors could not be detected with intraoperative transesophageal echocardiography even in a retrospective manner. We eventually performed aortic valve replacement. The tumors of the two cusps were pathologically diagnosed as papillary fibroelastoma. Of note, a macroscopically undetected tumor was identified in the right coronary cusp by histopathological evaluation. Careful intraoperative observation is essential for surgical decision and patient’s prognosis. It is also considered that latent tumor might be concealed even in seemingly normal adjacent cusps in a case with multiple papillary fibroelastomas.

The Absorbable Monofilament Suture Material in the Low Pressure Circulatory System / 日本心臓血管外科学会雑誌

Primary end-to-side anastomoses between the left upper pulmonary vein and left atrium performed in 21 puppies with continuous 5-0 polydioxanone (PDS) or polypropylene (PRO). Animals were sacrificed at 1, 7 and 28 days after operation. Stenosis occurred in one of 5 animals of the PDS group at 7 days and 28 days respectively, and one of 5 animals of the PRO group at 28 days. There was no significant difference between the two groups in terms of anastomosis patency. Histological examination showed slight tissue reaction and fibrosis surrounding the sutures in both groups. This study suggests that the absorbable monofilament suture material, in particular PDS, is useful for the repair of low pressure circulatory system and will not cause the stenosis of the anastomotic site.