JUAN A. CRESTANELLO: Welcome to the Cardiovascular Surgery Series, where I review the latest research in cardiovascular surgery from the Mayo Clinic in just 2 minutes. I am Dr. Juan Crestanello. I will discuss today the article entitled, operative management of cardiac papillary fiberoelastomas.
PFEs are the most common benign intracardiac tumor and are often associated with increased risk of a stroke or systemic embolization. We reviewed the records of 294 patients who had PFE resected at our institution between 1998 and 2020. The most common location of the PFE was the aortic valve followed by the mitral valve. Location of the PFE in the right side of the heart was very rare.
In 46% of the patients, the primary indication for surgery was the removal of the PFE. In those patients, a stroke or TIA was the most common symptom in 51% of the patients. When PFE was a secondary indication for surgery, PFE was identified preoperatively in only 40% of the patients. PFE was located in a normal valve in 79% of the patients. And in almost all those patients, the valve can be preserved, 96%, and the treatment consists on just shaving of the PFE, preserving the native valve.
The surgical risk was low with an operative mortality of 0% in primary PFEs. The rate of stroke was 2% in primary PFEs. The long-term survival at 10% was almost 80%. PFE recurs in almost 16% of the patients.
We conclude that the resection of papillary fibroelastomas can be performed safely with the preservation of the native valve and with low rates of neurological events. Operative and long-term outcomes after fibroelastoma resection are excellent. Thank you for listening to the Cardiovascular Surgery Series.