Giant left atrial myxoma with right atrial protrusion via atrial septal defect: echocardiographic and surgical correlation

Abstract

Cardiac myxomas are the most common primary tumors of the heart and are predominantly located in the left atrium. The clinical presentation depends on the site of implantation and the hemodynamic effect it generates. We present the case of a patient with an intracardiac mass attached to the interatrial septum that, on echocardiography, prolapsed into the right ventricle during diastole and was associated with dilatation of the right chambers. No atrial septal defect was evident on the preoperative study, so it was initially interpreted as a probable right atrial myxoma. During surgery, a pedicle implanted on the left side of the interatrial septum
was found, protruding through a previously undiagnosed wide atrial septal defect. A complete resection with septal closure was performed, with a favorable outcome.
This case highlights the importance of considering associated septal defects in atypical presentations and the need for correlation between echocardiographic and surgical findings.