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European Journal of Echocardiography Advance Access originally published online on June 13, 2009
European Journal of Echocardiography 2009 10(7):884-886; doi:10.1093/ejechocard/jep087
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

The role of intraoperative transoesophageal echocardiography in the diagnosis and management of a rare multiple fibroelastoma of aortic valve: a case report and review of literature

Giovanni Truscelli1, Concetta Torromeo1,*, Fabio Miraldi1, Claudia Vittori1, Paola F. Silenzi3, Antonio Caso2, Pietro Gallo3, Carlo Gaudio1 and Luigi Tritapepe4

1 Department of Heart and Great Vessels ‘Attilio Reale’, Sapienza University of Rome, viale del Policlinico 155, ‘Sapienza’, Rome 00161, Italy
2 Postgraduate School in Anesthesia and Reanimation, University of Foggia, Foggia, Italy
3 Experimental Medicine Department, Sapienza University of Rome, Rome, Italy
4 Department of Anesthesia, Reanimation, Critical Care Medicine and Analgesia, Sapienza University of Rome, Rome, Italy

Received 26 March 2009; accepted after revision 24 May 2009; online publish-ahead-of-print 13 June 2009.

* Corresponding author. Tel: +39 (0) 649972597; fax: +39 (0) 649970829. E-mail address: concetta.torromeo{at}uniroma1.it


  Abstract

Papillary fibroelastoma is the third most common primary tumour of the heart that usually involves the cardiac valves. Multiple papillary fibroelastomas are extremely rare. We report a case with multiple valve papillary fibroelastoma which was identified only by intraoperative transoesophageal echocardiography. The patient complained of atypical chest pains. She was affected by coronary artery disease and had previously had a myocardial infarct. This finding dictated a change in the operative approach. The aortic valve resection was performed in addition to coronary revascularization. If the intraoperative transoesophageal echocardiography was not performed, our patient would have had just coronary artery bypass graft surgery, probably without solving the symptoms. Furthermore, in future she would have undergone another cardiac operation for resection of aortic masses and valve replacement. The intraoperative use of Transoesophageal Echocardiography improves the diagnosis and the management of all cardiac surgical patients.

Keywords: Multiple fibroelastoma; Aortic valve; Intraoperative transoesophageal echocardiography; Coronary artery bypass graft surgery


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