Incidental finding of cardiac papillary fibroelastoma of the left ventricular outflow tract, associated with rheumatic mitral and tricuspid stenosis

Cardiac papillary fibroelastomas (CPFs) are one of the most common benign cardiac tumours. However, due to their location and pedunculated nature, they are associated with substantial complications secondary to systemic embolization or coronary ostial obstruction. Surgical resection should be offered to all patients when the mass is >1 cm in diameter. Valve-sparing excision produces good long-term results in most instances. We present the case of a young female scheduled for elective mitral and tricuspid valve replacement and maze procedure for chronic atrial fibrillation. A CPF was incidentally discovered during routine intraoperative transoesophageal echocardiography with an unusual location; at the left ventricular outflow tract.