Incidentally Detected Tricuspid Papillary Fibroelastoma

A 56-year-old man was admitted to our hospital for coronary artery bypass graft surgery. Preoperative transthoracic echocardiography revealed thickening of the anterior leaflet of the tricuspid valve, and transesophageal echocardiography showed oval and irregular-shaped masses, featuring well-demarcated borders and a homogenous texture, attached to the atrial side of the anterior leaflet of the tricuspid valve with a small, tiny, mobile stalk. In the operating room, this mass was resected and gross anatomical examination showed multiple finger-like fronds attached to the stalk. When it was placed in saline, the mass revealed typical “sea anemone”, suggestive of papillary fibroelastoma. Although echocardiography had been previously conducted for routine preoperative evaluation, this incidental finding significantly changed the surgical plan.