Intraoperative bronchoscopic resection of a papillary fibroelastoma in the left ventricular outflow tract after aortic mechanical valve replacement

We report the case of an 80-year-old man who 11 years previously had undergone aortic valve replacement (St. Jude Medical mechanical heart valve 23 mm) because of aortic stenosis. At the current presentation, a 7-mm pedunculated tumor was discovered along the septal wall in the left ventricular outflow tract. In an attempt to perform a less invasive procedure because of the patient’s advanced age, transaortic valve bronchoscopic resection was undertaken. A bronchoscope (Olympus BF P-200) was fed through a gap in the mechanical aortic valve. The entire tumor was removed using biopsy forceps, with histology revealing a papillary fibroelastoma. By using a bronchoscope, we avoided a second valve replacement.