What are the potential risks associated with left-sided cardiac tumors?
Retrospective studies have shown increased risk of stroke with left-sided cardiac myxoma and papillary fibroelastomas. Atrial myxomas can occur in any cardiac chamber but are noted most frequently in the left atrium and are felt to have greater embolic and thromboembolic potential. Papillary fibroelastomas are fibrinous mobile tumors occurring most frequently adherent to a cardiac valve with nearly equal distribution across the cardiac valves. In a single-center study of 323 patients after excision of a cardiac tumor, the Odds Ratio (OR) of embolism associated with left atrial tumors was 1.95 and higher (4.17) with aortic valve location. In another series of 725 patients with papillary fibroelastoma, tumor mobility and aortic valve location were independent predictors of embolism. Less common tumors and metastatic lesions in the heart have been anecdotally associated with stroke, however, there is not enough evidence to make a consistent recommendation for those circumstances.