Why the study?
A large thrombus entrapped in a patent foramen ovale is extremely rare, particularly after temporary inferior vena cava filter placement for venous thromboembolism.
Surgical embolectomy is a feasible and effective treatment for simultaneous intracardiac and pulmonary artery thrombus in the setting of PFO entrapment.
Rare PFO thrombus post-TIVCF may precipitate shock; leaves open optimal prevention strategies in VTE.
Background. A large thrombus entrapped in the patent foramen ovale (PFO) is an extremely rare condition. Moreover, it is considered even rarer after temporary inferior vena cava filter (TIVCF) placement for the prevention of fatal pulmonary embolism due to venous thromboembolism (VTE). Case Report. A 58-year-old man presented with syncope following chest pain and dyspnea due to PE exacerbation during TIVCF protection, which then led to cardiogenic shock. Echocardiography revealed a large thrombus entrapped in the PFO, and computed tomography (CT) showed a bilateral pulmonary artery embolism. The patient was treated with open surgical embolectomy for a pulmonary artery thrombus and PFO thrombus with simultaneous closure of the PFO. The patient’s postoperative course was uneventful. Results and Conclusion. Surgical embolectomy was useful with respect to the feasibility of resection of both intracardiac thrombus and pulmonary artery thrombus performed simultaneously, contributing to the prevention of systemic embolisms, and echocardiography plays an important role for early diagnosis.
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Nakamura et al. (2023) studied this question.
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