A Giant Right Atrial Myxoma Traverses through a Patent Foramen Ovale, Combined with Coronary Artery Bypass Grafting: A Case Report

Abstract

Cardiac myxoma is the most common primary heart tumor in adults, although it is rare and typically occurs in the left atrium. While this tumor is benign, immediate surgical resection is necessary due to the potential risks of embolism and stroke. We reported a rare case of a right atrial myxoma accompanied by a patent foramen ovale (PFO), pulmonary embolism, inferior vena cava (IVC) web, and coronary artery occlusion, for which the patient underwent surgery. The patient was a 66-year-old female with a history of percutaneous coronary intervention (PCI) two years prior. She arrived at the hospital experiencing severe dyspnea. Her heart rhythm was atrial fibrillation, and there was no report of polycythemia. Additionally, the patient's troponin I level was negative. Angiography was performed, confirming the presence of coronary artery disease (CAD). The echocardiography performed on the patient revealed a large atrial myxoma, along with a PFO and an IVC web. Following surgery, the patient was transferred to the ICU in stable condition. Postoperative histopathology confirmed the presence of a myxoma. A follow-up echocardiography showed that all of the patient's issues had been resolved, and the size of the right atrium had decreased. The patient was discharged after seven days. Due to multiple reported cases of cardiac myxoma after ablation, and considering our patient's history of PCI two years prior, it is advisable to conduct echocardiography following any cardiac intervention. Documenting medical history, and interventions performed on patients, along with their consequences, significantly contributes to the timely diagnosis and treatment of this disease.