Related Experiment Video
Updated: Nov 9, 2025

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Management of straddling thrombus through patent foramen ovale complicating pulmonary embolism
Vijeth Bhat1, Stuart Lane2, Sam Orde2
1John Hunter Hostpial, Intensive Care Unit, New Lambton Heights, New South Wales, Australia vijeth.bhat@health.nsw.gov.au.
Abstract:
A 60-year-old man was admitted to intensive care unit with the diagnosis of pulmonary embolism. Bedside transthoracic echocardiography revealed the extension of the thrombus into left atrium and ventricle through patent foramen ovale (PFO). A straddling thrombus also described as impending paradoxical embolism is a rare condition when thrombus embolised to the heart gets caught in PFO. Morbidity is extremely high in case of systemic embolisation. Due to rarity, the treatment options are mainly individualised and no guidelines exist. There are few treatment strategies described in literature from surgical to interventional radiology to conservative approach. Treatment strategy should take individual parameters such as patient's age, haemodynamic stability, bleeding risk and comorbidities into consideration. Our patient successfully underwent emergency surgical thrombectomy.
Related Concept Videos
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Pulmonary Embolism III: Nursing Management
Venous Thrombosis III: Interprofessional Care
Pulmonary Embolism I: Introduction
Mitral Stenosis III: Medical Management
Venous Thrombosis I: Introduction

