Primary Heart Tumors as a Cause of Embolization into the Central Nervous System: Ten-Years´ Experience

Czech version

Authors: R. Brát; J. Sieja; J. Štětinský
Authors‘ workplace: Kardiochirurgické centrum FNsP Ostrava
Published in: Cesk Slov Neurol N 2007; 70/103(3): 278-283
Category: Short Communication

Overview

The heart tumor is not a frequent cause of embolization into the central nervous system (CNS). The authors have presented their experience with this disorder and focused on patients in whom an embolizing cerebrovascular accident (ECVA) was the first manifestation of a tumor. Patients’ symptomatology, period between appearing the first symptoms up to diagnosing embolism, tumor location, method and outcome of therapy were assessed retrospectively. The results achieved in patients with and those without ECVA were compared. Within 1996–2006, 53 patients with the heart tumor were operated on, out of them 10 (18.9%) experienced ECVA. In ECVA patients, the tumor was located 9× in the left and 1× in the right atrium. In patients without ECVA, the tumor was situated in the left atrium 34×, in the right atrium 7×, in one case it protruded from the mitral valve, and duplicity was seen in two cases. Nine patients (21%) were quite asymptomatic. In patients without ECVA, the period from the first symptoms up to the diagnosis establishing ranged within 3 days – 2 years (mean 101 days). In ECVA sufferers, their interval ranged within 7 days – 16 months (mean 170 days). All the patients underwent a surgery. Perioperative mortality rate in groups with and without ECVA was 0% and 4.5%, respectively. The report has discussed the size of a set, representation of patients with ECVA, tumor location, symptomatology, period from the first symptoms up to the diagnosis establishing, and therapeutical results. The embolization of heart myxomas into the CNS is not a frequent but very severe symptom. Although this symptom should lead to very quick searching for the source of embolization, in practice the period from embolization to establishing the correct diagnosis has been still too long.

Key words:
heart tumor – myxoma – embolization – cerebrovascular accident

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