State of the Art: Evaluation and Management of Patients with Cardiac
Papillary Fibroelastoma
Abstract
Objective: To review the current literature on the state of the art of
evaluation and management of cardiac papillary fibroelastoma (PFE).
Methods: A literature review was performed on the topic of evaluation
and management of PFE. PubWeb, Web of Science, Google Scholar, Scopus
search engines were used. Key search terms included: “Cardiac papillary
fibroelastoma,” “papillary fibroelastoma,” “Surgical resection of
papillary fibroelastoma,” “Minimally invasive resection of papillary
fibroelastoma,” “Thoracoscopy and PFE.” Relevant articles were
archived and synthesized in an EndNote database. Particular attention
was focused on identifying cases of minimally invasive resection of PFE
and the use of thoracoscopic adjuncts to assist with cavitary PFE
removal. Institutional Review Board approval was waived. Results: A
total of 119 articles were identified and archived. Forty seven articles
were used to compose this paper. 8 articles detailed minimally invasive
resection of PFE. The largest series of minimally invasive PFE resection
summed 4 patients. There are currently no guidelines to direct care of
patients with PFE. General consensus is that the presence of left sided
PFE should prompt evaluation for surgery. Conclusions: PFE is a rare
tumor, more common in children than adults. Lesions are typically left
sided and are at risk for embolization. Minimally invasive surgery is
feasible and safe. Long-term outcomes with complete resection are very
good.