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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
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Thrombus in Transit through Patent Foramen Ovale
Hassan Baydoun1, Iskander Barakat1, Elie Hatem2
1Department of Medicine, Staten Island University Hospital, NY 10305, USA.
Case Reports in Cardiology
|May 15, 2014
Summary
A rare thrombus passing through a patent foramen ovale (PFO) can cause paradoxical embolism. Surgery is often best for low-risk patients, while anticoagulation suits those with high surgical risk or small PFOs.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Paradoxical embolism via a patent foramen ovale (PFO) is rare.
- Thrombi in transit are often identified post-mortem due to their transient nature.
Purpose of the Study:
- To report a case of a thrombus straddling a PFO diagnosed via echocardiography and treated surgically.
- To review existing literature on thrombi in transit through PFOs.
Main Methods:
- Case report and comprehensive literature review.
- Analysis of 88 previously reported cases.
Main Results:
- Surgery demonstrated fewer recurrent embolic events compared to thrombolysis and anticoagulation.
- Anticoagulant therapy is a viable alternative for high-risk surgical patients or those with small PFOs.
- Thrombolysis was associated with the highest mortality rates.
Conclusions:
- No definitive treatment consensus exists for thrombi in transit through PFOs.
- Surgery is recommended for patients not at high surgical risk.
- A treatment algorithm is proposed based on clinical scenarios, weighing surgery, anticoagulation, and thrombolysis.
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