Management of Incidental Aortic Valve Mass

Abstract

Aortic valve mass is an uncommon finding. Autopsy studies suggest prevalence of all cardiac neoplasms is 0.02%.1 Due to the rarity of the diagnosis, there is controversy regarding management. This is especially important as use of transesophageal echocardiography (TEE) becomes a standard for all cardiac surgeries. Also, with improved technology leading to higher resolution imaging, smaller lesions are increasingly identified. There are many different types of cardiac masses. Myxoma is the most common primary cardiac tumor in adults, followed by papillary fibroelastoma (PFE). However, in regards to valvular masses, PFE is the most common. Approximately 30% of PFE are asymptomatic and found incidentally at the time of cardiac surgery or at autopsy.2 It is important to understand the differential diagnosis and surgical implications when unexpected masses are discovered in the operating room. We present a case of an incidental aortic valve mass in a 65-year-old female presenting for coronary artery bypass grafting (CABG).