J Card Surg. 2019;1-3. wileyonlinelibrary.com/journal/jocs © 2019 Wiley Periodicals, Inc. | 1 DOI: 10.1111/jocs.14183 CASE REPORT Surgical treatment of cardiac fibroma in a child with left ventricular noncompaction Yosuke Sakurai MD | Yoshifumi Kunii MD | Minori Tateishi MD | Satoshi Okugi MD | Yuchen Cao MD | Masaaki Koide MD, PhD Department of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan Correspondence Yosuke Sakurai, MD, Department of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, 2‐12‐12 Sumiyoshi, Naka Ward, Hamamatsu, Shizuoka 430‐8558, Japan. Email: yokke1689@gmail.com Abstract Surgical treatment of cardiac fibroma is rare in patients with left ventricular noncompaction (LVNC). Although several case reports regarding cardiac fibroma have been published, resection in a patient with LVNC has not been described. Here, we describe the surgical treatment of left ventricular fibroma in a child with LVNC. We resected a cardiac fibroma in a 10‐year‐old boy with LVNC to control ventricular arrhythmia. Partial resection with careful tumor dissection was performed to avoid endocardial damage and entering the ventricular cavity. The postoperative course was uneventful, and the patient remains asymptomatic without heart failure or arrhythmia. Surgical excision of cardiac fibroma can be performed safely with excellent results, even in a child with LVNC. KEYWORDS cardiac fibroma, left ventricular noncompaction 1 | INTRODUCTION Cardiac fibroma is the second most common primary cardiac tumor among children. 1 Surgical resection may be required for life‐threatening arrhythmias, with complete resection being performed if feasible, although partial resection can also alleviate arrhythmia. 2 We describe the surgical treatment of left ventricular (LV) fibroma in a child with left ventricular noncompaction (LVNC). Despite numerous case reports regarding cardiac fibroma have been published, resection in a patient with LVNC has not been described. Careful attention is required to preserve postoperative LV function and intracardiac structures. 2 | CASE REPORT A 10‐year‐old boy was admitted to our hospital because an electro- cardiographic abnormality was found during medical examination at school. Transthoracic echocardiography showed a 30‐mm tumor at the LV apex adjacent to the posterior papillary muscle, but mitral regurgitation was not observed. Computed tomography (CT) revealed a large apical cardiac tumor (35 × 28 mm) with central calcification (Figure 1A). Cardiac magnetic resonance imaging confirmed a large, well‐circumscribed LV mass. CT and transesophageal echocardiography both showed prominent LV trabeculation, and the ratio of the noncompacted to compacted layers was 2.4, fitting the diagnostic criteria for LVNC (Figure 1B and 1C). Premature ventricular contrac- tions (PVCs) were detected via exercise electrocardiography, therefore, surgical resection was scheduled. Surgery was performed via median sternotomy. Total cardiopul- monary bypass was established with aortobicaval cannulation. A whitish‐yellow tumor was identified at the apex. We marked the incision line before infusion of cardioplegic solution. Incision was commenced from the tumor surface at the LV apical anterior wall, and the mass was excised using Beaver blades (Alcon Surgical Inc, Fort Worth, TX; Figure 2A). Because the border between the tumor and the myocardium was unclear, meticulous dissection was performed to prevent papillary muscle damage and to avoid entering the ventricular cavity. The defect was closed with a double‐layer 4‐0 polyvinylidene fluoride running suture and autologous pericardium, and the patient was weaned from bypass without difficulty. Pathologic examination revealed benign intracardiac fibroma (Figure 2B and 2C). Postoperative echocardiography showed no residual mass