Catheter Directed Removal of a Cardiac Calcified Amorphous Tumor

Document Type

Conference Proceeding

Publication Date

4-2-2024

Publication Title

Journal of the American College of Cardiology

Abstract

Background: Cardiac calcified amorphous tumors (cardiac CAT) are rare tumors with fewer than 100 cases reported in literature. Little is known about the pathogenesis of cardiac CAT with no concrete guidelines on management. We describe the case of a cardiac CAT patient who presented with an embolic stroke. Case: The patient was a 34 year old female, with a history including lupus, end stage renal disease (ESRD), and atrial fibrillation (AF) off anticoagulation, who presented for evaluation of confusion and visual changes in the setting of recent weight loss. A head CT suggested multifocal strokes in bilateral hemispheres and cerebella which were confirmed by MRI. A transthoracic echocardiogram revealed a mass rising from the left atria which protruded across the mitral valve. The decision was made to pursue catheter-based retrieval and the mass was extirpated. Pathology revealed nodular calcium deposits consistent with cardiac CAT. Decision-making: The patient was deemed a poor surgical candidate due to her ESRD and poor functional status so a minimally invasive approach was selected utilizing AngioVac. Our patient was a perfect substrate for thromboembolism given her history of lupus, anticardiolipin positive antibodies, and AF. As such, she was bridged to warfarin after tumor removal. Conclusion: Cardiac CATs remain a rare diagnosis without a clear ideal approach for tumor removal and subsequent anticoagulation. Further documentation will be needed in the future to clarify how to manage these patients.

Volume

83

Issue

13 Suppl

First Page

3892

Comments

American College of Cardiology 73rd Annual Scientific Session & Expo, April 6-8, 2024, Atlanta, GA

DOI

10.1016/S0735-1097(24)05882-0

Link to Full Text

Share

COinS