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.