title: Usefulness of CHA2DS2-VASc Scoring Systems for Predicting Risk of Perioperative Embolism in Patients of Cardiac Myxomas Underwent Surgical Treatment.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Ling
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Xue
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China.
authors.forename: Zhinong
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003661:Decision Support Techniques; D004617:Embolism / Q000453:epidemiology*; D005260:Female; D006338:Heart Neoplasms / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D009232:Myxoma / Q000150:complications* / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D018570:Risk Assessment