Key result
Cardiac embolectomy, PFO closure, and pulmonary thromboendarterectomy resolve impending paradoxical embolism from trapped thrombi.
Case Report (n=2)
Surgical embolectomy combined with PFO closure and pulmonary thromboendarterectomy is a viable therapeutic option for patients with impending paradoxical embolism from a trapped thrombus in a patent foramen ovale.
Surgical embolectomy with PFO closure may be feasible in select cases of impending paradoxical embolism; leaves open optimal management pending larger prospective studies.
We report two cases of impending paradoxical embolism through a patent foramen ovale. A 73-year-old male had recurrent pulmonary embolism and a large thrombus trapped in a patent foramen ovale. The other patient, a 70-year-old male had septic mediastinitis after prior bypass surgery and a large thrombus lodged in a patent foramen ovale. Cardiac embolectomy and closure of the foramen ovale was performed in both cases because of impending paradoxical embolism. In addition pulmonary thromboendarterectomy was performed to relieve pulmonary hypertension. Therapeutical options are discussed.
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Falk et al. (1997) conducted a case report in Trapped thrombus in a patent foramen ovale (n=2). Cardiac embolectomy and closure of the foramen ovale was evaluated. Cardiac embolectomy and closure of the foramen ovale, along with pulmonary thromboendarterectomy, were performed to treat impending paradoxical embolism in two patients with trapped thrombi.
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