BLOOD CYSTS OF THE CARDIAC VALVES IN ADULTS Review and analysis of
published cases
Abstract
Background and aim of the study: Blood cysts of cardiac valves are
generally seen in newborns and infants and very rarely in adults.
Although in most cases they are incidental findings they may be
associated to severe cardiac or systemic complications. This study
analyzes incidence, presentation and treatment of valvular blood cysts
in adults. Methods: A review of the pertinent literature through a
search mainly on PubMed and Medline was performed. Results: In patients
≥ 18 years of age, our search disclosed 54 patients with mitral blood
cysts (mean age, 48±18 years), 9 with a tricuspid valve cyst (mean age,
67±15 years), 3 with a blood cyst on the pulmonary valve (age 31, 43 and
44 years) and 1 aortic valve cyst in a 22-year-old man. Most patients
were asymptomatic while stroke, syncope or myocardial infarction
occurred in 6 patients with a mitral valve cyst. Blood cysts were
removed surgically in 70% of patients with a mitral cyst, in 55% with
a tricuspid cyst and in all those with a pulmonary or aortic cyst. At
histology the cyst wall was composed mainly by fibrous tissue and with
the inner surface lined with typical endothelium. Conclusions: Blood
cysts of cardiac valves are rare in adults but may cause
life-threatening complications particularly when located on the mitral
valve. For such reason surgical removal appears advisable, with low-risk
procedures. Widespread use of multimodality imaging techniques will most
likely increase the number of valvular blood cysts diagnosed also in
adults.