Refractory ascites - a rare presentation of severe aortic regurgitation.

A 47 year-old male with a history of refractory ascites presented to our centre complaining of dyspnoea, abdominal distention, and weight gain. He was admitted under a medical team for investigation and management. Work-up excluded all common aetiologies of ascites. Echocardiography revealed severe aortic regurgitation (AR) with a dilated left ventricle but no right heart pathology or pulmonary hypertension. He underwent mechanical aortic valve replacement. Intra-operatively, a prolapsing left coronary leaflet of the aortic valve with frayed edges raised suspicion of resolved infective endocarditis. Postoperative course was uneventful. Following replacement of the aortic valve, the patient was completely free of ascites. This case demonstrates that ascites can be an unusual clinical presentation of severe aortic regurgitation, which may respond to aortic valve replacement.

Papillary fibroelastoma of the interventricular septum: mimicking a cardiac myxoma.

Papillary fibroelastomas are benign cardiac tumors that involve cardiac valves. These tumors are usually asymptomatic and are found incidentally during cardiac surgery or during echocardiographic evaluation in a patient who exhibits cardiac symptoms. However, these tumors may cause major thromboembolic complications. Herein, we describe the surgical management of a patient who had an unusual appearance and location of a papillary fibroelastoma that was attached to the interventricular septum.