We planned surgical resection of the myxoma on earlier basis. On-table Transesophageal Echocardiography (TEE) showed patent foramen ovale (PFO) with right-to-left shunting because of raised right atrial pressure and dynamic obstruction of the tricuspid valve by the right atrial myxoma. Our approach was via median sternotomy. Standard aorto-bicaval cannulation was done. Cardiopulmonary bypass was established. The myxoma was pedunculated and it was attached to anteromedial aspect of RA-IVC junction with extension to IVC [Figure 1]. The myxoma was resected via trans-RA (right atrial) approach. IVC extension of the tumor was removed by going into total circulatory arrest (TCA). The PFO was closed primarily [Figure 2]. The surgical specimen was sent for histopathological examination and came out to be a myxoma.

Post-operative period was uneventful and the saturation at room air of the patient was 100% and she was discharged on day 7. The Patient is doing well during the 3-month follow-up period.