Life-threatening arrhythmias from dynamic LVOT obstruction by a large left ventricular fibroma in an adolescent: complete resolution after combined transaortic-transatrial resection—a case report

TL;DR

A 15-year-old boy with a large heart tumor causing dangerous arrhythmias was successfully treated with a combined surgical approach.

Contribution

Demonstrates a successful surgical strategy for treating a rare cardiac fibroma in adolescents.

Findings

A large left ventricular fibroma caused life-threatening arrhythmias and syncope in an adolescent.

Combined transaortic-transatrial resection completely resolved the obstruction and symptoms.

Early surgical intervention led to a favorable prognosis with no residual tumor.

Abstract

Cardiac fibromas are benign tumors that infrequently cause hemodynamic compromise or arrhythmias, particularly in adolescents. We describe a 15-year-old male who presented with nonspecific symptoms evolving into recurrent dizziness and syncope due to a large left ventricular (LV) fibroma obstructing the LV outflow tract (LVOT). Complicated by ventricular fibrillation arrest, the case underscores the potential for life-threatening events. Surgical excision via a combined transaortic and transatrial approach resulted in complete resolution, with no residual mass prior to discharge. This report highlights the diagnostic challenges, surgical strategy, and favorable prognosis, emphasizing early intervention in symptomatic pediatric cardiac tumors.

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