Central retinal artery occlusion as the initial sign of aortic valve papillary fibroelastoma

López-Sánchez, E.; Muñoz, Ester Frances; Martinez, Juan A Aviño; Rozalen, José Luis Menezo

doi:10.1016/s0002-9394(00)00846-1

Cited by 15 publications

(9 citation statements)

References 4 publications

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“…5 The majority of patients with CPF are asymptomatic, however, CPF may present with cerebrovascular events, angina, myocardial infarction, sudden cardiac death, heart failure, syncope, pulmonary embolism, peripheral embolism, or vision loss as in our case. 1,6,7 CPF may cause chest pain, myocardial infarction or sudden cardiac death by direct occlusion of the coronary ostia or by embolization to the coronary arteries. A comprehensive analysis of 725 CPF cases demonstrated that tumor mobility is the only independent predictor of CPF-related death or nonfatal embolism.…”

Section: Discussionmentioning

confidence: 99%

A Rare Cause of Sudden Vision Loss in a Young Male: Papillary Fibroelastoma of the Aortic Valve

et al. 2007

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Cardiac papillary fibroelastoma (CPF) is a rare cardiac neoplasm predominantly affecting the cardiac valves. Although it is most commonly an incidental finding, it can result in life-threatening complications, such as coronary and cerebral embolism, acute valvular dysfunction, and sudden death. In this report, we describe a case of a patient with aortic valve papillary fibroelastoma, which presented with sudden vision loss due to branch retinal artery occlusion. To the best of our knowledge, this is the third case of CPF-related retinal artery embolism in English literature.

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Section: Discussionmentioning

confidence: 99%

A Rare Cause of Sudden Vision Loss in a Young Male: Papillary Fibroelastoma of the Aortic Valve

et al. 2007

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“…The noncoronary leaflet of the aortic valve is most often affected. 3,4 Most PFEs are incidentally found on echocardiograms and are clinically silent; however, symptoms can occur after embolization and give rise to a wide variety of presenting features, including neurologic events (such as transient ischemic attack [TIA], stroke, amaurosis fugax, and spinal cord infarction), [5][6][7] acute coronary syndrome, 8,9 and distal thromboembolism. 10 Very few systemic or comprehensive study results have been published to validate a single medical or surgical approach to rarer primary cardiac tumors like PFE, so we reviewed our institution's surgical experience with PFE during a 22-year period.…”

Section: Single-institution Experience With 14 Surgical Patientsmentioning

confidence: 99%

Cardiac Papillary Fibroelastoma: Single-Institution Experience with 14 Surgical Patients

Saleh¹,

Jabbari²,

Ramlawi³

et al. 2016

Texas Heart Institute Journal

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In general, treatment for symptomatic and asymptomatic cardiac papillary fibroelastoma is surgical resection-particularly of left-sided lesions, because of the risk of systemic embolization. However, few institutions have enough experience with these tumors to validate this approach. We present our institutional experience with papillary fibroelastoma and discuss our current approach. We searched our institution's cardiac tumor database, identified all patients diagnosed with cardiac papillary fibroelastoma from 1992 through 2014, and recorded the clinical and pathologic characteristics of each case. We found 14 patients (mean age, 60.5 ± 12.3 yr) who had 18 lesions. Eleven patients (79%) were symptomatic; however, we could not always definitively associate their symptoms with a cardiac tumor. Most lesions were solitary and ≤1.5 cm in diameter; half involved the left side of the heart. All 18 lesions were surgically excised. There were no operative or 30-day deaths, and no patient needed valve replacement postoperatively. There was one late death; at one year, another 3 patients were lost to follow-up, and the others were alive without tumor recurrence. Because of the embolic risk inherent to intracardiac masses and our relatively good postoperative outcomes, we recommend the surgical resection of all left-sided papillary fibroelastomas in surgical candidates, and we discuss with patients the advisability of resecting right-sided lesions.

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“…In the majority of our patients (57%), the PFE was symptomatic with the most common being a thromboembolic event (pulmonary emboli, transient ischemic attack, cerebrovascular accident, peripheral embolus) (69%). Other documented embolic complications include retinal artery occlusion, myocardial infarction, ischemic extremity, and mesenteric ischemia [19–24]. Others report symptoms resulting from partial or complete obstruction of valves, ventricular outflow tract, or blood vessels, leading to pulmonary edema, myocardial infarction, heart failure, syncope, or sudden death [25–29].…”

Section: Commentmentioning

confidence: 99%

Surgical Experience With Cardiac Papillary Fibroelastoma Over a 15-Year Period

Anastacio

Moon

Damiano

et al. 2012

The Annals of Thoracic Surgery

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Background Papillary fibroelastomas are rare, benign cardiac tumors. They are predominantly asymptomatic. However, they can lead to serious complications, namely thromboembolic events. Symptomatic lesions can be managed primarily with surgical excision and valvular preservation. Controversy exists as to the management of asymptomatic lesions. Methods All patients diagnosed with cardiac papillary fibroelastoma between 1996 and 2012 at a single institution were queried for clinical and pathologic characteristics. Results Twenty-three patients with 29 lesions were identified. Most lesions were solitary, less than 1.0 cm in diameter, and occurred in patients greater than 60 years of age. The most common presentation was thromboembolic complication. All were managed successfully with surgical excision. One patient developed a recurrence or metachronous lesion within 3 months of initial surgical intervention. Conclusions Papillary fibroelastomas are rare, benign, predominantly asymptomatic cardiac tumors that can cause potentially serious complications. The natural history and etiology of papillary fibroelastomas are largely unknown. Controversy exists over the management of asymptomatic lesions. However, there is consensus that symptomatic lesions should undergo surgical excision with valvular preservation when possible. A unique case of a possible papillary fibroelastoma recurrence is also described.

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Central retinal artery occlusion as the initial sign of aortic valve papillary fibroelastoma

Cited by 15 publications

References 4 publications

A Rare Cause of Sudden Vision Loss in a Young Male: Papillary Fibroelastoma of the Aortic Valve

A Rare Cause of Sudden Vision Loss in a Young Male: Papillary Fibroelastoma of the Aortic Valve

Cardiac Papillary Fibroelastoma: Single-Institution Experience with 14 Surgical Patients

Surgical Experience With Cardiac Papillary Fibroelastoma Over a 15-Year Period

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