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Updated: May 11, 2025

A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
Transesophageal echocardiography as the final defense in impending paradoxical embolism: a case report
Zhuangyuan Chen1, Mingjing Chen2, Haibo Song3
1Department of Anesthesiology, The University of Hongkong-Shenzhen Hospital, Shenzhen, 518053, Guangdong, People's Republic of China.
Background:
Impending paradoxical embolism (IPDE) involves venous thrombi crossing a patent foramen ovale, posing high risks of systemic embolization.
Case Presentation:
A 64-year-old male was admitted to the operation theater due to heart failure symptoms, with the original plan of undergoing atrial mass resection and mitral valve replacement. Intra-operative transesophageal echocardiography (TEE) diagnosed the patient with IPDE and acute pulmonary embolism. And this critical diagnosis immediately altered the surgical decision-making process, which included pulmonary artery thrombectomy. The successful treatment of this case was significantly attributed to the intraoperative TEE examination, which provided essential real-time diagnostic information guiding the surgical approach. This case highlighted the importance of intra-operative TEE in management of IPDE for surgical planning.
Conclusions:
TEE is the final defense in IPDE. To optimize surgical outcomes and avert misdiagnosis, routine utilization of intraoperative TEE is highly recommended for similar cases.
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