First case report of atrial myxoma in interauricular occlusive device in Colombia

Primary cardiac tumors are extremely rare; myxomas are the most common benign type in adults. Although percutaneous closure of ostium secundum atrial septal defects (osASD) using occluder devices is a standard and safe procedure, the development of a cardiac mass on these devices is a rare event that requires careful differential diagnosis among thrombi, endocarditis, and neoplasms.

A 58-year-old woman with a history of an osASD corrected percutaneously with an occluder device in 2021 presented 3 years later for routine follow-up. Transesophageal echocardiography revealed a mobile, heterogeneous, lobulated mass attached to the left atrial disk of the device. Due to the high risk of systemic embolization, surgical intervention was scheduled. A median sternotomy and atriotomy confirmed a gelatinous mass adhering to the device. The mass and the occluder were completely resected, followed by reconstruction of the interatrial septum using a bovine pericardial patch. Histopathological analysis confirmed a cardiac myxoma. The postoperative course was favorable, with complete functional recovery.

This represents the first reported case in Colombia of an atrial myxoma arising from an ASD occluder device. Although rare, this complication highlights the importance of long-term echocardiographic surveillance after percutaneous cardiac interventions. Surgical resection remains the gold standard treatment to prevent embolic events and obtain a definitive histological diagnosis.

This case describes the first Colombian report of a cardiac myxoma associated with a percutaneous interatrial closure device, emphasizing the need for a comprehensive differential diagnosis of late intracardiac masses.