Cardiac Myxoma Post-Transseptal Ablation: Coincidence or Causation?

A Case Report | Open Access

Volume 2025 - 4 | Article ID 265 | http://dx.doi.org/10.51521/WJCRCI.2025.e41.410

Cardiac Myxoma Post-Transseptal Ablation: Coincidence or Causation?

Academic Editor: John Bose

Received 2025-06-11
Revised 2025-06-17
Accepted 2025-06-18
Published 2025-06-20

Resha Reya Ganthan MD¹, Ezra Schrem MD⁴, Asher Gorantla MD⁴, Nidal Isber MD, FACC, FHRS^2,3, Gautham Upadhya MD, FACC², Francesco Rotatori MD, FACC²

¹Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA

²Department of Cardiology, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA

³Department of Electrophysiology, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA

⁴Department of Cardiology, State University of New York Downstate, Brooklyn, NY, USA

Corresponding Author: Resha Reya Ganthan MD, Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA.

Citation: Resha Reya Ganthan, Ezra Schrem, Asher Gorantla, Nidal Isber, Gautham Upadhya, Francesco Rotatori, (2025) Cardiac Myxoma Post-Transseptal Ablation: Coincidence or Causation?: A Case Report. World J Case Rep Clin Imag. 2025 June; 4(1)1-8.

Copyrights: © Resha Reya Ganthan, et al., 2025, This article is licensed under the Creative Commons Attribution-Non Commercial-4.0-International-License-(CCBY-NC) (https://worldjournalofcasereports.org/blogpage/copyright-policy). Usage and distribution for commercial purposes require written permission.

Abstract

Background: Cardiac myxomas are benign cardiac neoplasms usually found solitarily located within a single cardiac chamber, most commonly in the left atrium. With no established cause, they are often thought to occur spontaneously with no particular genetic cause or external incitement. While it has been explored, there is no universally accepted correlation with myxoma formation following a cardiac ablation procedure. We propose the theory of an iatrogenic causation of cardiac myxoma formation, likely incited by the local tissue injury during the transseptal puncture of the interatrial wall.

Case Summary: We present the case of a 62-year-old male with a medical history significant for Atrial Fibrillation for which he underwent a transseptal ablation procedure, during which a puncture is made through the interatrial septum. Transthoracic and transesophageal echocardiograms obtained prior to the procedure did not reveal any intracardiac masses or abnormalities. Two-years post-procedure, during an inpatient hospitalization for a suspected asthma exacerbation, a new transthoracic echocardiogram demonstrated a pedunculated mass within the left atrium.

Take Home Message(s)

· Cardiac myxomas are the most common benign cardiac neoplasms, often thought to be of sporadic origin, however are in part influenced by familial genetic disorders

· Cardiac myxomas may iatrogenically develop through a metaplastic process triggered by tissue injury during transseptal ablation procedures

Keywords: Coronary Artery Disease (CAD).

Abbreviations:

ACS: Acute coronary syndrome

CAD: Coronary artery disease

CNC: Carney Complex

CT: Computed tomography

EKG: Electrocardiogram

ESR: Erythrocyte sedimentation rate

MACE: Major adverse cardiovascular event

MRI: Magnetic resonance imaging

NSTEMI: Non ST-segment elevation myocardial infarction