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. 2015 Apr 22:21:1146-54.
doi: 10.12659/MSM.893855.

Risk factors for embolism in cardiac myxoma: a retrospective analysis

Deng-Ke He  1 , Yu-Feng Zhang  1 , Yin Liang  1 , Shi-Xing Ye  2 , Chong Wang  3 , Bo Kang  1 , Zhi-Nong Wang  1
Affiliations

Risk factors for embolism in cardiac myxoma: a retrospective analysis

Deng-Ke He et al. Med Sci Monit. .

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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Figures

Figure 1
Figure 1
(A) Atrial myxoma seen in two-dimensional echocardiography. (B) Atrial myxoma diagnosed by three-dimensional reconstruction of spiral computed tomography. (C) Myxoma seen after removal. (D) Perioperative picture.
Figure 2
Figure 2
Two types of myxomatous surface. (A) Irregular or villous surface and soft consistency (irregular type). (B) Smooth surface and compact consistency (polypoid type).
Figure 3
Figure 3
The histologic morphological observations and immunohistochemical staining of myxomas.
See this image and copyright information in PMC

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