Myxomas are mainly located in the atria (75% in the left and 15–20% in the right) and are attached to the atrial septum, usually in the region of the rim of the fossa ovalis (Figures 2 & 3).

Then, trans-septal puncture of the interatrial septum is ideally performed at the fossa ovalis to gain access to the left atrium. The patient should then be heparinized to an activated clotting ...