A6

The correct answer is B, the lesion is most commonly seen on the mitral or aortic valve. The lesion shown in the TEE aortic long axis image has the classic appearance of a papillary fibroelastoma. Papillary fibroelastomas are the second most common primary cardiac tumor, the most common being myxoma. They are the most common tumors seen on cardiac valves. There are seen much more frequently on left sided valves. Papillary fibroelastomas are generally not associated with severe valvular regurgitation. Many are small and discovered incidentally. Not all will require surgery. Though some have suggested anticoagulation in patients with suspected papillary fibroelastomas to prevent thrombus formation and embolism, the only effective therapy for large lesions is surgical resection