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Mesothelial or monocytic incidental cardiac excrescence (MICE) is a rare, benign lesion composed of a mixture of mesothelial and inflammatory cells, histiocytes and fibrin without a vascular network usually accidentally found during cardiac surgery or after cardiac catherization. We report the case of a 45-year-old man admitted for suspected myxoma on the mitral valve. The lesion was removed via a minimally invasive video-assisted approach, without compromising the valve competency. The histopathological exam led to the diagnosis of MICE. The 2-yearfollow-up echocardiography confirmed normal mitral function without recurrence. Most of the cases were treated concomitantly to other cardiac procedure, lesions were more frequently founded in the left cardiac chambers or valves, our experience suggest that these lesions should be safely treated alone by surgical removal, to prevent embolic events.

Objective: To assess the results of tricuspid annuloplasty performed with the Edwards MC3 remodeling ring. Methods: From 2005 to 2007, 140 patients with tricuspid regurgitation (TR) secondary to left-sided valve disease (mean age 63.8 +/- 11.6, permanent pacemaker in 7.8%, LVEF 56.4 +/- 10.1%, LVEDD 54.1 +/- 8 mm, SPAP 52.5 +/- 14.4 mmHg) underwent tricuspid annuloplasty using the MC3 ring. Dilatation of the tricuspid annulus was present in all patients. Other concomitant mechanisms of TR (moderate leaflet prolapse, pacemaker wires, leaflets' retraction) were documented in 21 cases (15%). All patients underwent concomitant left-sided valve surgery. Ring size was between 28 and 32 in 84.3% of patients. Results: Hospital mortality was 3.5% and actuarial survival at 3 years 94.8 +/- 2.1%. Mean follow-up of the 135 hospital survivors was 22 +/- 9.5 months (median 23 months). Echocardiography at hospital discharge documented no or mild TR in 119 patients (87%), moderate TR (2+/4+) in 15 (11%) and moderate-to-severe (3+/4+) in 1 patient (0.7%). At echocardiographic follow-up moderate TR was present in 14 patients (10.3%) and moderate-to-severe TR in 2 (1.4%). At 3 years freedom from TR >= 2+ was 88.1 +/- 2.78% and freedom from TR >= 3+ was 94.3 +/- 4.89. Predictors of TR >= 2+ at hospital discharge and at follow-up were preoperative LVEF (OR:0.8; p = 0.001 at discharge; HR:0.9; p = 0.003 at follow-up) and the presence of other mechanisms of TR besides annular dilatation (OR:10.8; p = 0.007 at discharge; HR:6.1; p = 0.003 at follow-up). Conclusion: Tricuspid annuloplasty with the MC3 ring provides satisfactory early results which remain stable at mid-term follow-up. The presence of other mechanisms besides annular dilatation leads to residual valve insufficiency after ring annuloplasty alone. doi: 10.1111/j.1540-8191.2012.01443.x (J Card Surg 2012;27:288-294)