Transcatheter Relief for Lipomatous Hypertrophy of an Interatrial Septum Obstructing Superior Vena Cava in an Elderly Patient.

backgroundLipomatous hypertrophy of the interatrial septum (LHIS) is a benign cardiac tumor involving nonencapsulated fat. While usually asymptomatic, it may rarely lead to hemodynamic compromise. CASE SUMMARY: An 83-year-old man with ischemic cardiomyopathy presented with worsening dyspnea. Evaluation revealed in-stent restenosis of the right coronary artery, which was treated percutaneously. Symptoms persisted, prompting cardiac magnetic resonance, which identified LHIS causing obstruction of ≥50% of the superior vena cava (SVC). Given favorable anatomy, percutaneous SVC stenting was performed. At 6-month follow-up, the patient was symptom-free with improved cardiac output. DISCUSSION: Although LHIS is typically benign, it can cause significant venous obstruction. This case highlights the value of multimodality imaging and introduces percutaneous stenting as a minimally invasive alternative to surgery in selected patients. TAKE-HOME MESSAGES: Multimodality imaging is key in LHIS diagnosis. Percutaneous SVC stenting can be a safe, effective option in high-risk patients.