Embolic Potential of Cardiac Tumors and Outcome After Resection : A Case-Control Study

• Published in: Stroke (1970) 2009, Vol.40 (1), p.156-162
• Main Authors: ELBARDISSI, Andrew W, DEARANI, Joseph A, DALY, Richard C, MULLANY, Charles J, ORSZULAK, Thomas A, PUGA, Francisco J, SCHAFF, Hartzell V
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aortic Valve - pathology; Aortic Valve - surgery; Biological and medical sciences; Cardiac Surgical Procedures - mortality; Cardiac Surgical Procedures - statistics & numerical data; Case-Control Studies; Cerebrovascular Disorders - epidemiology; Cohort Studies; Comorbidity; Embolism - mortality; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Heart Atria - pathology; Heart Atria - surgery; Heart Neoplasms - mortality; Heart Neoplasms - pathology; Heart Neoplasms - surgery; Humans; Intensive care medicine; Intracranial Embolism - mortality; Male; Medical sciences; Middle Aged; Mitral Valve Insufficiency - epidemiology; Neurology; Pulmonary Embolism - pathology; Retrospective Studies; Risk Assessment; Risk Factors; Survival Rate; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.108.525709

Embolic events have long been thought to occur in patients with cardiac tumors secondary to embolization of tumor fragments; however, there are no large studies examining the epidemiology and occurrence of embolism in this group of patients. From 1957 to 2006, 323 consecutive patients with primary cardiac tumors were treated surgically at our institution. Of these, patients who experienced an embolic event included 80 (cerebrovascular accident 31 [9.7%], transient ischemic attack 30 [9.3%], and other 19 [6%]). Those with no history of an embolic event (n=243 [75%]) were defined as control subjects. Age was similar between the case and control groups (mean 54.5 versus 53.9 years, P=0.8). A multivariate logistic regression model including tumor location, tumor burden, tumor histology, and cerebrovascular risk factors, indicated that left atrial tumors (OR, 1.95; P=0.04), aortic valve tumors (OR, 4.17; P=0.002), and smaller tumor burden (OR, 2.20; P=0.01) were the most significant factors in the occurrence of embolism (P