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Risk factors for embolism in cardiac myxoma: a retrospective analysis.

He DK, Zhang YF, Liang Y, Ye SX, Wang C, Kang B, Wang ZN - Med. Sci. Monit. (2015)

Bottom Line: Preoperative data, including platelet count, sex, age, and the tumor (size, location, surface, and attachment), were compared between embolic and non-embolic groups of patients.No significant differences in vascular risk factors were seen between the 2 groups.However, the percentage of higher platelet count (>300 × 10(9)/L) and mean platelet volume in the embolic group were significantly higher than in the non-embolic group (P=0.0356, and 0.0113, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China (mainland).

ABSTRACT

Background: Myxomas are the most common primary heart tumors and are closely associated with embolic events. Cardiac myxomas typically arise from the interatrial septum at the border of the fossa ovalis in the left atrium. Any other location is considered atypical. Embolism, one of the complications of myxoma, is associated with high morbidity and mortality. The aim of this study was to investigate the risk factors for embolism in patients with cardiac myxoma.

Material and methods: In this retrospective study, a cohort of 162 patients with cardiac myxomas was surgically treated between January 1998 and June 2014 at 3 cardiac centers in China. Preoperative data, including platelet count, sex, age, and the tumor (size, location, surface, and attachment), were compared between embolic and non-embolic groups of patients.

Results: No significant differences in vascular risk factors were seen between the 2 groups. However, the percentage of higher platelet count (>300 × 10(9)/L) and mean platelet volume in the embolic group were significantly higher than in the non-embolic group (P=0.0356, and 0.0113, respectively). Irregular surface and atypical location of the myxomas were also independently associated with increased risk of embolic complications.

Conclusions: Tumor location, macroscopic appearance, mean platelet volume, and high platelet count are strong risk factors for embolic events in patients with cardiac myxomas.

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Two types of myxomatous surface. (A) Irregular or villous surface and soft consistency (irregular type). (B) Smooth surface and compact consistency (polypoid type).
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f2-medscimonit-21-1146: Two types of myxomatous surface. (A) Irregular or villous surface and soft consistency (irregular type). (B) Smooth surface and compact consistency (polypoid type).

Mentions: Based on clinical presentation and cranial computed tomography, patients were classified into embolic and non-embolic groups. Patients’ clinical profile was retrieved, including sex, age, body surface area, body mass index, history of atrial fibrillation or flutter, concomitant valvular heart disease, pulmonary artery hypertension, coronary artery disease, blood coagulation function, intravascular ultrasound, and characteristic features of the myxomas (size, appearance, location, attachment). Typical myxomas arise from the interatrial septum at the border of the fossa ovalis in the left atrium. Atypical myxomas arise from other sites of the left atrium or in the other cardiac chambers [9]. Macroscopically, the surface of myxomas is classified into 2 types (Figure 2): the irregular type has a surface with a soft consistency and multiple exquisite villous extensions on the surface, and an irregular or villous surface; and the polypoid type has a compact consistency with polypoid appearance and smooth surface [7,10–12].


Risk factors for embolism in cardiac myxoma: a retrospective analysis.

He DK, Zhang YF, Liang Y, Ye SX, Wang C, Kang B, Wang ZN - Med. Sci. Monit. (2015)

Two types of myxomatous surface. (A) Irregular or villous surface and soft consistency (irregular type). (B) Smooth surface and compact consistency (polypoid type).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4418206&req=5

f2-medscimonit-21-1146: Two types of myxomatous surface. (A) Irregular or villous surface and soft consistency (irregular type). (B) Smooth surface and compact consistency (polypoid type).
Mentions: Based on clinical presentation and cranial computed tomography, patients were classified into embolic and non-embolic groups. Patients’ clinical profile was retrieved, including sex, age, body surface area, body mass index, history of atrial fibrillation or flutter, concomitant valvular heart disease, pulmonary artery hypertension, coronary artery disease, blood coagulation function, intravascular ultrasound, and characteristic features of the myxomas (size, appearance, location, attachment). Typical myxomas arise from the interatrial septum at the border of the fossa ovalis in the left atrium. Atypical myxomas arise from other sites of the left atrium or in the other cardiac chambers [9]. Macroscopically, the surface of myxomas is classified into 2 types (Figure 2): the irregular type has a surface with a soft consistency and multiple exquisite villous extensions on the surface, and an irregular or villous surface; and the polypoid type has a compact consistency with polypoid appearance and smooth surface [7,10–12].

Bottom Line: Preoperative data, including platelet count, sex, age, and the tumor (size, location, surface, and attachment), were compared between embolic and non-embolic groups of patients.No significant differences in vascular risk factors were seen between the 2 groups.However, the percentage of higher platelet count (>300 × 10(9)/L) and mean platelet volume in the embolic group were significantly higher than in the non-embolic group (P=0.0356, and 0.0113, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China (mainland).

ABSTRACT

Background: Myxomas are the most common primary heart tumors and are closely associated with embolic events. Cardiac myxomas typically arise from the interatrial septum at the border of the fossa ovalis in the left atrium. Any other location is considered atypical. Embolism, one of the complications of myxoma, is associated with high morbidity and mortality. The aim of this study was to investigate the risk factors for embolism in patients with cardiac myxoma.

Material and methods: In this retrospective study, a cohort of 162 patients with cardiac myxomas was surgically treated between January 1998 and June 2014 at 3 cardiac centers in China. Preoperative data, including platelet count, sex, age, and the tumor (size, location, surface, and attachment), were compared between embolic and non-embolic groups of patients.

Results: No significant differences in vascular risk factors were seen between the 2 groups. However, the percentage of higher platelet count (>300 × 10(9)/L) and mean platelet volume in the embolic group were significantly higher than in the non-embolic group (P=0.0356, and 0.0113, respectively). Irregular surface and atypical location of the myxomas were also independently associated with increased risk of embolic complications.

Conclusions: Tumor location, macroscopic appearance, mean platelet volume, and high platelet count are strong risk factors for embolic events in patients with cardiac myxomas.

Show MeSH
Related in: MedlinePlus