The ultimate proof of paradoxical embolism and a percutaneous solution

Central venous catheters (CVCs) and ports are frequently used for the administration of total parenteral nutrition, antibiotics, and chemotherapeutic agents. Their use may be associated with serious complications, such as venous thrombosis, embolization, and catheter rupture. Catheter fragments most commonly embolize to the right atrium, right ventricle, and pulmonary artery (Surov et al., Angiology 2008;59:90-97). We report the first case of a CVC that embolized across a patent foramen ovale (PFO) into the left atrium in a 72-year-old female who presented with symptoms of a transient ischemic attack (TIA). Treatment consisted of retrieving the embolized portacath, which had lodged in the right upper pulmonary vein followed by percutaneous PFO closure.