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Case report
Cardiac papillary fibroelastoma originating from the coumadin ridge and review of literature
  1. Hassan Mehmood Lak1,
  2. Connor Charles Kerndt2,
  3. Shinya Unai3 and
  4. Anjli Maroo4
  1. 1Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
  2. 2Internal Medicine, Spectrum Health, Grand Rapids, Michigan, USA
  3. 3Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA
  4. 4Cardiovascular Medicine, Fairview Hospital, Cleveland, Ohio, USA
  1. Correspondence to Connor Charles Kerndt; Kerndtconnor{at}


Papillary fibroelastomas represent the second most common benign cardiac tumour, secondary only to cardiac myxoma. A majority of patients are asymptomatic on presentation. The most common clinical manifestations include stroke, transient ischaemic attack, myocardial infarction and angina. Echocardiography remains the primary imaging modality for identification of these tumours. The majority of papillary fibroelastomas arise from the valves. Simple surgical excision is the mainstay of treatment, carrying an excellent prognosis. We present an unusual case of cardiac papillary fibroelastoma originating from the coumadin ridge (CR) in a 70-year-old woman. The patient exhibited increasing paroxysms of her atrial fibrillation and was pursuing a MAZE procedure. Preoperatively, a transesophageal echocardiogram revealed a 0.7×1 cm intracardiac mass that had echocardiographic appearance of a fibroelastoma. Surgical resection and MAZE procedures were performed. The gross specimen and histopathology findings were consistent with papillary fibroelastoma. This case reports the seventh documented case of fibroelastoma originating from the CR.

  • interventional cardiology
  • cancer - see oncology
  • cardiothoracic surgery
  • surgical oncology

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  • Contributors HML: Primary investigator of this case report. Synthesised the case presentation, case outcomes and treatment sections. Collected and formulated figures. Assisted in editing process. CCK: Formulated a majority of the Discussion and Introduction section of this case report. Conducted a review of literature and synthesised its results in a table. SU: Reviewed the document in its entirety making significant editing. Provided surgical viewpoint for the piece. AM: Senior author. Provided several series of reviews and oversight throughout the synthesis process. Provided cardiovascular viewpoint to the piece. All authors significantly contributed to the synthesis of this publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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