Surgical Treatment for Massive Pulmonary Embolism and a Thrombus Crossing a Patent Foramen Ovale: Impending Paradoxical Embolism

• Published in: Japanese Journal of Vascular Surgery Vol. 23; no. 5; pp. 878 - 881
• Main Authors: Ito, Fusahiko, Watanabe, Masazumi, Katsumata, Chieko
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY FOR VASCULAR SURGERY 2014; 特定非営利活動法人 日本血管外科学会
• Subjects: impending paradoxical embolism; patent foramen ovale; pulmonary embolism; 切迫奇異塞栓; 卵円孔開存; 急性肺塞栓症
• ISSN: 0918-6778; 1881-767X
• DOI: 10.11401/jsvs.14-00015

A 47-year-old man was admitted to our institution complaining severe dyspnea. The ultrasound cardiograph showed marked dilatation of right ventricle, pulmonary hypertension estimated 56 mmHg and the floating thrombi of bilateral atrium. The enhanced CT revealed thrombosis of bilateral pulmonary artery. An emergency operation was performed. The right atrium was opened under cardiac arrest and a tubular thrombus trapped in the patent foramen ovale was removed. Also massive fresh thrombi were removed from the bilateral main pulmonary artery. The patient discharged without symptoms. Early surgical treatment is necessary for avoiding paradoxical embolisms.