Tumor Embolism From a Right Atrial Myxoma Leads to Acute Right Heart Failure After Surgery and Atrial Septal Patch Dehiscence

Sivakumar, Kothandam; Singhi, Anil Kumar; Mohanraj, Anbarasu; Janakiraman, Ezhilan

doi:10.1016/j.jacc.2014.02.608

Cited by 7 publications

(6 citation statements)

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“…The CHA 2 DS 2 -VASc score scheme is accurate and is both easily and widely used in prediction of severity and outcome of strokes, providing decision-making management in patients with AF1718. As demonstrated in previous studies, an incremental deterioration of left ventricle (LV) systolic and diastolic dysfunction may cause left atrium (LA) enlargement, which is strongly associated with the occurrence of postoperative atrial fibrillation (POAF) which is associated with stroke or embolism1621, and whose underlying mechanism were similar to patients with myxomas.…”

Section: Discussionmentioning

confidence: 99%

“…Included patients were carried out surgery of tumor resection to treat cardiac myxomas with or without valve surgeries and other concomitant cardiac surgeries. Patients with history of recent myocardial infarction (MI) (less than one month), deep venous thrombus (DVT), preoperative renal or hepatic failure, infective endocarditis were excluded318.…”

Section: Methodsmentioning

confidence: 99%

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Usefulness of CHA2DS2-VASc Scoring Systems for Predicting Risk of Perioperative Embolism in Patients of Cardiac Myxomas Underwent Surgical Treatment

Liang

Wang

et al. 2016

Sci Rep

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Cardiac myxomas are rare but manifested with risk of embolism and often cause unexpected symptoms or sudden death. We retrospectively collected the medical records of patients diagnosed of cardiac myxomas at the cardiac center of our university. Overall 465 patients were included in this study, patients in the embolism group had significantly higher CHA2DS2-VASc scores (P = 0.005). In embolic group, stroke was recorded in 110 (77.14%) patients, while embolic events in the limbs were observed in 10 (2.15%) and 9(1.93%) developed splenic infarction. Patients in embolism group had older age (P = 0.021) and higher BMI (P <0.001) than those in non-embolism group. There was no significant difference between two groups in terms of time of mechanical ventilation (P = 0.065), ICU stay (P = 0.053), hospital stay (P = 0.071) and volume of drainage (P = 0.083), blood transfusions (P = 0.060) except that patients with embolic events had significantly higher incidence of postoperative atrial fibrillation (P = 0.032) and lower survival rate (P < 0.001). Furthermore, the CHA2DS2-VASc score was a significant predictor of embolism in patients with cardiac myxomas (P = 0.015; P = 0.003) and the Kaplan-Meier analysis obtained a higher rate of embolism in patients with higher stratification of CHA2DS2-VASc scores (P = 0.002). In conclusion, CHA2DS2-VASc scoring scheme was strongly predictive of stroke and embolic events in patients with cardiac myxomas.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Usefulness of CHA2DS2-VASc Scoring Systems for Predicting Risk of Perioperative Embolism in Patients of Cardiac Myxomas Underwent Surgical Treatment

Liang

Wang

et al. 2016

Sci Rep

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“…Embolism is a major complication occurring in 30–50% of patients with cardiac myxomas, and is closely associated with cardiac mortality, especially preoperative [ 7 , 8 ]. Despite prompt thrombolytic therapy or embolectomy, sequelae of embolism still remain.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Embolism in Cardiac Myxoma: A Retrospective Analysis

Zhang

Liang

et al. 2015

Med Sci Monit

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BackgroundMyxomas 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/MethodsIn 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.ResultsNo significant differences in vascular risk factors were seen between the 2 groups. However, the percentage of higher platelet count (>300×109/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.ConclusionsTumor 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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“…Główne powikłanie, występujące u 30-50% pacjentów, stanowi zatorowość ściśle powiązana ze śmiertelnością, zwłaszcza przedoperacyjną. Dotyczy ona głównie naczyń mózgowych, rzadziej wieńcowych, nerkowych oraz kończyn dolnych i górnych [5]. www.journals.viamedica.pl/folia_cardiologica Dariusz Dąbrowski i wsp., Śluzak lewej komory serca Opis przypadków Przypadek 1.…”

Section: Wstępunclassified

“…W badaniach laboratoryjnych wykazano podwyższone stężenie fibrynogenu do 6,4 (1, [1,5], 5) i D-dimerów do 5,03 (0-0,5). W badaniu echokardiograficznym w lewej komorze stwierdzono niewielki, mocniej wysycony owalny guzek pomiędzy mięśniami brodawkowatymi bocznym i przyśrodkowym o wymiarach 5 mm × 4 mm.…”

Section: Wstępunclassified