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BLOOD CYSTS OF THE CARDIAC VALVES IN ADULTS Review and analysis of published cases
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  • Uberto Bortolotti,
  • Igor Vendramin,
  • Andrea Lechiancole,
  • Sandro Sponga,
  • Angela Pucci,
  • Aldo Milano,
  • Ugolino Livi
Uberto Bortolotti

Corresponding Author:[email protected]

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Igor Vendramin
University Hospital, Udine
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Andrea Lechiancole
University Hospital of Udine
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Sandro Sponga
University Hospital of Udine
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Angela Pucci
Azienda Ospedaliero Universitaria Pisana
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Aldo Milano
Università degli Studi di Bari Aldo Moro
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Ugolino Livi
University Hospital of Udine
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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.
19 Aug 2021Submitted to Journal of Cardiac Surgery
20 Aug 2021Submission Checks Completed
20 Aug 2021Assigned to Editor
23 Aug 2021Reviewer(s) Assigned
01 Sep 2021Review(s) Completed, Editorial Evaluation Pending
01 Sep 2021Editorial Decision: Accept
Dec 2021Published in Journal of Cardiac Surgery volume 36 issue 12 on pages 4690-4698. 10.1111/jocs.15992