Key result
Emergency surgical thrombectomy was successfully performed in a 60-year-old man with a straddling thrombus through a patent foramen ovale complicating pulmonary embolism.
Why the study?
Straddling thrombus through a patent foramen ovale is a rare condition with high morbidity from systemic embolisation, and no guidelines exist for its treatment.
Case Report (n=1)
Emergency surgical thrombectomy can be a successful treatment strategy for the rare and high-risk condition of straddling thrombus through a patent foramen ovale complicating pulmonary embolism.
Adds to sparse evidence on surgical thrombectomy for this rare entity; leaves open optimal management strategies.
A 60-year-old man was admitted to intensive care unit with the diagnosis of pulmonary embolism. Bedside transthoracic echocardiography revealed the extension of the thrombus into left atrium and ventricle through patent foramen ovale (PFO). A straddling thrombus also described as impending paradoxical embolism is a rare condition when thrombus embolised to the heart gets caught in PFO. Morbidity is extremely high in case of systemic embolisation. Due to rarity, the treatment options are mainly individualised and no guidelines exist. There are few treatment strategies described in literature from surgical to interventional radiology to conservative approach. Treatment strategy should take individual parameters such as patient's age, haemodynamic stability, bleeding risk and comorbidities into consideration. Our patient successfully underwent emergency surgical thrombectomy.
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Bhat et al. (2021) conducted a case report in Pulmonary embolism with straddling thrombus through patent foramen ovale (n=1). Emergency surgical thrombectomy was evaluated. Emergency surgical thrombectomy was successfully performed in a 60-year-old man with a straddling thrombus through a patent foramen ovale complicating pulmonary embolism.
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