Deutsche medizinische Wochenschrift (1946) · 2018
[Papillary Fibroelastoma of the Pulmonary and Tricuspid Valve in Asymptomatic Patients].
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Kavalerchyk Vladyslav, Staudt Alexander, Stoebe Stephan, Hagendorff Andreas, Wöhlke Michael
Аннотация
HISTORY: Case 1: admission to hospital of a 72-year-old male patient due to suspect tumor at the pulmonary valve. At admission the patient was hemodynamically stable with known coronary one vessel heart disease and arterial hypertension.Case 2: admission to hospital of a 74-year-old female patient due to symptoms of de novo angina pectoris with known coronary three vessel heart disease.
FINDINGS AND DIAGNOSIS: In both patients suspect tumors could have been detected at the pulmonary- and tricuspid valve by transthoracic echocardiography. In case 1 coronary angiography showed a complex coronary three vessel heart disease with indication for surgery. In case 2 coronary angiography showed a subtotal stenosis of the RCA which could have been treated by percutaneous coronary intervention (PCI).
THERAPY AND COURSE: In both cases the tumor were highly suspective to be benigne. Despite of the certain risk of embolism, surgery was only recommended in case 1 because the patient needed surgical revascularisation anyway due to the complex coronary three vessel heart disease. In case 2 the RCA stenosis has been treated by PCI and surgery has not been recommended.
CONCLUSIONS: Echocardiography can help to detect cardiac tumors whereas the diagnosis can only be confirmed by biopsy. Further therapeutic procedures should be defined individually.
FINDINGS AND DIAGNOSIS: In both patients suspect tumors could have been detected at the pulmonary- and tricuspid valve by transthoracic echocardiography. In case 1 coronary angiography showed a complex coronary three vessel heart disease with indication for surgery. In case 2 coronary angiography showed a subtotal stenosis of the RCA which could have been treated by percutaneous coronary intervention (PCI).
THERAPY AND COURSE: In both cases the tumor were highly suspective to be benigne. Despite of the certain risk of embolism, surgery was only recommended in case 1 because the patient needed surgical revascularisation anyway due to the complex coronary three vessel heart disease. In case 2 the RCA stenosis has been treated by PCI and surgery has not been recommended.
CONCLUSIONS: Echocardiography can help to detect cardiac tumors whereas the diagnosis can only be confirmed by biopsy. Further therapeutic procedures should be defined individually.