Pulmonary embolism and intracardiac shunt: a unique indication for operation

Pulmonary embolism with right-to-left intracardiac shunt presents a special problem for the clinician. A review of the literature and 4 personal cases, all diagnosed antemortem, are presented. On the basis of this information certain conclusions are drawn, and we suggest the problem to be a unique indication for the consideration of surgical intervention.