Prognostic and Bioepidemiologic Implications of Papillary Fibroelastomas
Papillary fibroelastomas (PFE) are benign neoplasms with little available outcome data. Mayo Clinic researchers, Kyle Klarich, M.D., conducted a study published in the Journal of the American College of Cardiology to describe the frequency and clinical course of patients with surgically removed PFE and echocardiographically suspected, but unoperated, PFE.
Mayo Clinic pathology and echocardiography databases were used during the study, resulting in 511 patients which included patients with surgically removed, histopathologically confirmed PFE. Group 1A had PFE removed at primary surgery, while group 1B had PFE removal at time of another cardiac surgery. Group two consisted of patients had echocardiographic evidence of PFE but no cardiac surgery to remove PFE.
During the study period, researchers identified 112 cardiac myxomas in the pathology database and 142 in the echocardiographic database. PFE occurred most commonly on cardiac valves. In group one, transient ischemic attack or stroke was the presenting symptom in 32 percent of patients. With surgical removal of valvular PFE, the valve was preserved in 98 percent of patients. Recurrence was documented in 1.6 percent of patients.
Based on these results, patients with echocardiographically suspected PFE who do not undergo surgical removal, present increased rates of cerebrovascular accident and mortality.