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Trapped thrombus in a patent foramen ovale
V Falk1, T Walther, H Krankenberg
1Department of Cardiac Surgery, University of Leipzig, Germany.
The Thoracic and Cardiovascular Surgeon
|April 1, 1997
Summary
Two patients with paradoxical embolism through a patent foramen ovale underwent successful cardiac embolectomy and foramen ovale closure. Pulmonary hypertension was also addressed, highlighting crucial therapeutic options.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Patent foramen ovale (PFO) is a potential route for paradoxical embolism.
- Recurrent pulmonary embolism and septic mediastinitis are serious conditions that can be complicated by PFO.
Observation:
- Two male patients, aged 73 and 70, presented with critical conditions involving a large thrombus trapped in a patent foramen ovale.
- The 73-year-old experienced recurrent pulmonary embolism, while the 70-year-old had septic mediastinitis post-bypass surgery.
Findings:
- Both patients underwent emergent cardiac embolectomy and PFO closure to prevent impending paradoxical embolism.
- Pulmonary thromboendarterectomy was also performed in one case to manage associated pulmonary hypertension.
Implications:
- This case series underscores the importance of recognizing PFO as a source of paradoxical embolism in complex clinical scenarios.
- Prompt surgical intervention, including embolectomy and PFO closure, can be life-saving.
- Management strategies for associated pulmonary hypertension should also be considered.