[Aortic valve papillary fibroelastoma found at reoperation after open mitral commissurotomy; report of a case].

In 1982, a 63-year-old woman underwent open mitral commissurotomy for rheumatic mitral stenosis. She was referred to our hospital for surgical treatment of mitral restenosis in 2003. Preoperative echocardiography showed rheumatic mitral valve restenosis and demonstrated a mobile mass of the aortic valve. During the operation, a mitral valve replacement was performed using prosthetic valve (SJM 29 mm) and a tricuspid valve was repaired by annuroplasty (De Vega). Through the aortotomy, a multiple frond-like tumor, measuring 5 mm, was found attached to the free-edge of the left-coronary cusp of the aortic valve. The resection of the tumor was performed without valve replacement. The histopathologic diagnosis was papillary fibroelastoma. The postoperative course was uneventful. In the pathogenesis of this case, the iatrogenic factor may have played a role in tumor development.