Abstract
We report the case of a 37-year-old man who experienced sudden right hemiparesis and aphasia. Transcranial Doppler echocardiography showed occlusion of the M3 segment of the left middle cerebral artery. Cranial computed tomography showed an ischemic lesion in the left caudate nucleus and capsule lenticular region. Intravenous recombinant tissue plasminogen activator and mechanical thrombectomy were attempted unsuccessfully. Subsequently, a transesophageal echocardiogram showed a mass measuring 7 mm attached to the anterior leaflet of the mitral valve at the level of A3 (Figure 1). Cardiac computed tomography confirmed a 7-mm mass attached to the anterior leaflet of the mitral valve (Figure 2). The patient underwent video-assisted surgery through a right minithoracotomy. Cardiopulmonary bypass was established via the right femoral vein and femoral artery cannulation. The aorta was clamped with an EndoClamp. The tumor was resected during video-assisted surgery (Figure 3, Video 1). The postoperative course was uneventful, and the patient was discharged home 5 days after surgery. Histological examination confirmed a papillary fibroelastoma.
Transesophageal echocardiogram. The arrow indicates the fibroelastoma. Cardiac computed tomography. The arrow indicates the fibroelastoma. High-definition camera view of the operative field. The arrow indicates the fibroelastoma.
Footnotes
Acknowledgements
The authors thank Catelan Zborowski Anelise for proofreading.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.