[A paradoxical air embolism in a closed foramen ovale]

This case report deals with a patient who was being operated on for a tumor of the colon and who died from a paradoxical venous air embolism. Accompanying massive blood loss impedes differentiation of hemodynamic disturbances either due to venous air embolism or to hemorrhage, respectively. Air was aspirated from the radial artery catheter that was used for blood-pressure monitoring and for taking blood samples for laboratory analysis. At autopsy, no probe-patent foramen ovale could be demonstrated. The mechanism of air passing from the venous to the systemic circulation in our patient remains speculative; however, mechanical cardiopulmonary reanimation itself with its underlying thoracic pump mechanism has to be considered as contributing to the transport of air from the venous to the arterial side of the circulation.