Impending paradoxical embolus after massive pulmonary thromboembolism
Patent foramen ovale is a frequent congenital defect and when associated with pulmonary thromboembolism, leads to a worse prognosis of increasing the risk of systemic paradoxical embolisms. An unusual case is presented of an impending paradoxical embolism in a 54 year-old male with massive pulmonary...
| Autores: | , , , , , |
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| Formato: | artículo |
| Fecha de publicación: | 2019 |
| País: | España |
| Recursos: | Conselleria de Salut i Consum del Govern de les Illes Balears |
| Repositorio: | Docusalut |
| Idioma: | español |
| OAI Identifier: | oai:docusalut.com:20.500.13003/17351 |
| Acesso em linha: | https://hdl.handle.net/20.500.13003/17351 |
| Access Level: | acceso abierto |
| Palavra-chave: | Paradoxical embolism Transesophageal echocardiography Pulmonary embolism Patent foramen ovale |
| Resumo: | Patent foramen ovale is a frequent congenital defect and when associated with pulmonary thromboembolism, leads to a worse prognosis of increasing the risk of systemic paradoxical embolisms. An unusual case is presented of an impending paradoxical embolism in a 54 year-old male with massive pulmonary thromboembolism. Using trans-oesophageal echocardiography, an image was obtained of a large thrombus in transit between the two atria through a patent foramen ovale. Emergency surgical intervention was performed by carrying out a thrombectomy through the right atrium and pulmonary embolectomy, with good results. The incidence of impending paradoxical embolus is extremely low, and for this reason this case represented a diagnostic and therapeutic challenge. Surgery was the treatment of choice, as it is associated with better results in terms of survival and incidence of post-operative embolic events in comparison with chronic anticoagulation and thrombolysis, although each patient should be carefully selected. |
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