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Updated: Aug 19, 2025

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Life-threatening paradoxical thromboembolism in a patient with patent foramen ovale
Antonio Rizza1, Francesco Negro2, Tommaso Gasbarri3
1Cardiology Unit, Ospedale del Cuore, Fondazione Toscana "G. Monasterio", Massa, Italy.
Background:
Venous thromboembolism represents the third most frequent acute cardiovascular syndrome worldwide. Its clinical manifestations are deep vein thrombosis and/or pulmonary embolism. Despite a considerable mortality, diagnosis is often missed. CASE PRESENTATION: We report the management of a female patient with high-risk pulmonary thromboembolism treated initially with thromboaspiration, complicated by embolus jailing in a patent foramen ovale. In this situation, left cardiac chambers and systemic circulation were jeopardized by this floating embolus.
Conclusions:
High-risk pulmonary embolism requires reperfusion strategy but sometimes mechanical thromboaspiration may be not fully successful; transesophageal echocardiography led to a prompt diagnosis of this unexpected finding; in this very particular case, open surgery represented a bail-out procedure to avoid cerebral and systemic embolism.
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