Complete detachment of cardiac myxoma causing aortic saddle embolization and cerebral infarction

A 30-year-old previously healthy male was brought to our emergency room with loss of consciousness and convulsion. Physical examination showed that the femoral arterial pulses were absent. Two-dimensional transthoracic and transesophageal echocardiography showed no evidence of intracardiac thrombus or tumor or of aortic dissection. Brain magnetic resonance imaging study showed cerebral infarction involving anterior and bilateral hemispheres. He died of multiple organ failure after admission. Autopsy showed aortic saddle embolization caused by a myxomatous-like material. Histological examination of the embolic material confirmed the diagnosis of myxoma. There was a stalk on the left atrial septum which might possibly represent the site of attachment of the myxoma. This case suggested that a cardiac myxoma completely detached from the left atrial septum and caused aortic saddle embolization.