Frequency, Clinical Characteristics, Anatomical Distribution, and Outcomes of Embolic Complications of Cardiac Myxoma in Contemporary Cohorts: Protocol for a Systematic Review and Meta-Analysis.

BACKGROUND

Cardiac myxomas (CMs) are the commonest benign primary cardiac tumors, most frequently originating from the left atrium and occasionally from the right atrium. Despite being histologically benign, CMs can cause myriad serious embolic complications, including stroke, acute coronary syndrome, limb ischemia, and visceral infarction. While previous studies have explored risk factors for embolization, there is a lack of papers comprehensively summarizing the frequency, anatomical distribution, clinical patterns, and management of CM-related embolization.

OBJECTIVE

This review aims to provide a comprehensive synthesis of embolic complications associated with CMs, highlighting patterns, management strategies, and gaps in the current literature.

METHODS

A systematic review will be conducted in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. MEDLINE, Embase, Scopus, CINAHL, the Cochrane Library, and PubMed will be searched for studies reporting embolic complications in patients with histologically or radiologically confirmed CMs. Eligible study designs include large case series, cohort studies, and registries. Six reviewers will independently perform title and abstract and full-text screening in pairs across 3 screening groups, with disagreements resolved through discussion and senior reviewer adjudication where necessary. Data will be extracted by 3 reviewers, with the extracted data independently verified for accuracy. Discrepancies will be resolved through discussion or third-party adjudication. Risk of bias will be assessed using the Joanna Briggs Institute tools.

RESULTS

The review will summarize reported frequencies and anatomical distribution of embolic events, clinical presentations, associations with tumor characteristics, and management strategies. Title and abstract screening were completed in early April 2026, and full-text screening commenced in late April 2026. Data extraction and synthesis were completed in May 2026. We anticipate publication of the findings in September 2026.

CONCLUSIONS

This review aims to provide a comprehensive synthesis of embolic complications associated with CMs, highlighting patterns, management strategies, and gaps in the current literature. The findings aim to improve clinical recognition, inform clinical management, and guide future research.