A 74-year-old man with multiple aortic aneurysms and shaggy aorta was simultaneously treated by conventional open repair for an abdominal aortic aneurysm and endoluminal stent grafting for a thoracic aortic aneurysm. We performed intermittent clamping of the visceral and carotid arteries under an extracorporeal circulation circuit without a blood flow pump, which lead to the avoidance of embolization in spite of the disadvantage of endoluminal stent grafting for atheromatous aorta.
Papillary fibroelastoma is a rare, benign cardiac tumor. Surgical resection is indicated to prevent embolization. We herein report a case of a 78-year-old asymptomatic man who was found to have a mobile left ventricular papillary fibroelastoma anchoring deep in the left ventricle by incidental transthoracic echocardiography. The tumor was resected under visualization by a video-assisted rigid endoscope with a flexible head inserted through the aortic valve into the left ventricle. Intraoperative frozen section analysis provided a pathological diagnosis of papillary fibroelastoma. The postoperative course was uneventful. This technique is recommended for the observation and resection of a tumor anchoring deep in the left ventricle and is helpful for avoiding the adverse effects of left ventriculotomy.
An 84-year-old woman was referred to our hospital with a suspected cardiac tumor detected by transthoracic echocardiography performed as a preoperative examination of gastric cancer. In addition to a tumor in the left atrium, we found on cardiac ultrasound a 15-mm mobile tumor that adhered to the aortic valve. Gross findings and histological examination confirmed that the tumor in the left atrium was a cardiac myxoma, and that the tumor adhered to the aortic valve was a papillary fibroelastoma. We experienced a rare case where preoperative examination before gastrectomy accidentally revealed concomitant cardiac tumors.
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