Key result
On-pump open beating-heart surgical embolectomy successfully treated a massive bilateral pulmonary embolism and entrapped thrombus in a patent foramen ovale, resulting in 1-year symptom-free survival.
Case Report (n=1)
On-pump open beating-heart surgery is a viable and effective strategy for treating acute pulmonary thromboembolism with an entrapped thrombus in a patent foramen ovale, particularly in patients with severe right ventricular dysfunction.
May support surgical embolectomy in select massive PE with PFO thrombus; hypothesis-generating and should not yet change practice.
INTRODUCTION: Entrapped thrombus in a patent foramen ovale is a rare form of right heart thromboembolism. Various treatments have been used, such as anti-coagulation and thrombolytic therapy, vena cava filter, percutaneous thrombectomy and surgical embolectomy. CASE PRESENTATION: A 60-year-old Kosovan woman was admitted to our hospital with a massive bilateral pulmonary thromboembolism, entrapped thrombus in the patent foramen ovale and severe right ventricular dysfunction. The patient underwent on-pump beating-heart removal of the intracardiac thrombus and bilateral pulmonary embolectomy with the use of a Fogarty catheter. The patient's post-operative course was uneventful. In this report, we describe for the first time in this pathology, to the best of our knowledge, a surgical strategy that seems to offer an excellent outcome in patients with severe right ventricular dysfunction. CONCLUSIONS: The chosen surgical technique, consisting of on-pump open beating-heart surgery, is a unique procedure in the treatment of an acute pulmonary thromboembolism and entrapped thrombus in a patent foramen ovale.
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Prifti et al. (2015) conducted a case report in Massive bilateral pulmonary embolism and entrapped thrombus in a patent foramen ovale (n=1). On-pump open beating-heart surgical embolectomy was evaluated on Survival and symptom resolution. On-pump open beating-heart surgical embolectomy successfully treated a massive bilateral pulmonary embolism and entrapped thrombus in a patent foramen ovale, resulting in 1-year symptom-free survival.
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