Floating right atrial mass in a patient with suspected chronic thromboembolic pulmonary hypertension

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Publication Details

Journal
Pirogov Russian Journal of Surgery
Published
2026-09-14
DOI
https://doi.org/10.17116/hirurgia2026092148
Primary Topic
Pulmonary Hypertension Research and Treatments
Type
article
Field-Weighted Citation Impact
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article

Floating right atrial mass in a patient with suspected chronic thromboembolic pulmonary hypertension

А. М. Осадчий, I.Kh. Zugurov, И. В. Сухова, М. Л. Гордеев et al.
Pirogov Russian Journal of Surgery
Pulmonary Hypertension Research and Treatments
article

Floating right atrial mass in a patient with suspected chronic thromboembolic pulmonary hypertension

А. М. Осадчий, I.Kh. Zugurov, И. В. Сухова, М. Л. Гордеев, О. М. Моисеева, М. A. Simakova, I.V. Belyaninova
article en

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a late complication of acute pulmonary embolism (PE), characterized by persistent elevation of pulmonary artery pressure and pulmonary vascular resistance due to narrowing and/or obstruction of pulmonary arteries. In some cases, thromboembolic obstruction of pulmonary artery branches may occur without pulmonary hypertension after PE (chronic thromboembolic disease - CTED). Importantly, treatment strategies for CTED and CTEPH differ. Difficulties arise in determining the optimal management for patients with previous PE, CTEPHtypical lesions on CT pulmonary angiography and mobile right heart mass (tumor, thrombus, vegetation), particularly when right heart catheterization carries a high risk of complications. We present a 50-year-old female with previous massive PE. Followup examination revealed a mobile right atrial mass interpreted as "myxoma/thrombus" and signs of thromboembolic involvement of the right pulmonary artery branch. The patient underwent surgical removal of the right atrial mass and pulmonary thromboendarterectomy from the right pulmonary artery branch. Morphological examination confirmed organized thrombi in pulmonary artery branches and a large "old" thrombus in the right atrial cavity attached to the Eustachian valve by thin connective tissue strands. This case illustrates diagnostic challenges of CTED/CTEPH in the presence of intracardiac masses and underscores the role of surgical methods in diagnosis and treatment.

Pirogov Russian Journal of Surgery(9)
Federal Almazov North-West Medical Research Centre (RU)
Good health and well-being
Openalex Percentile: Top 13%
Pulmonary Hypertension Research and Treatments
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