The patient underwent median sternotomy to resect the mass as myxoma was considered based on imaging characteristics. LA was entered via the right atrium. A large fresh and organized thrombus was found attached to the interatrial septum via a thin cord. Multiple fragments of red-tan-brown soft clot measuring 6.5 x 6.5 x 3.0 cm in aggregate. A lamellated organized clot was also removed by vascular surgeons from the right popliteal artery using a Fogarty balloon technique. There was no PFO on TEE. There was a small organized left atrial appendage thrombus also. A Maze procedure and a 45 mm Atriclip was applied to the base of the left atrial appendage. There was no atrial myxoma on pathology.