For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
193
views
1
references
 Top references
cited by
0
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      112
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Large Biatrial Thrombembolus Caught in Transit across a Patent Foramen Ovale

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background In rare cases of pulmonary embolism, large thrombemboli have been found entrapped in a patent foramen ovale (PFO).

          Case Description A patient was referred to our center with leg swelling and dyspnea. Electrocardiogram showed sinus tachycardia and right axis deviation. Echocardiography revealed a highly mobile biatrial thrombus entrapped in a PFO extending to both tricuspid and mitral valves and prolapsing into the left ventricle. Urgent surgery for cardiac thrombectomy and PFO closure was performed. Intraoperatively, massive coherent thrombus material was extracted.

          Conclusion Because of a lack of data, decision making has to rely on clinical judgment rather than evidence.

          Most cited references1

          • Record: found
          • Abstract: found
          • Article: not found

          Impending paradoxical embolism: systematic review of prognostic factors and treatment.

          Patrick O Myers, Henri Bounameaux, Aristotelis Panos … (2010)
          Little is known about the optimal management of impending paradoxical embolism (IPDE), a biatrial thromboembolus caught in transit across a patent foramen ovale. Our aim was to review observational studies on this subject to identify prognostic factors and to compare mortality and systemic embolism between treatments. Systematic literature searches in Medline, Embase, and Cochrane Library identified 154 studies (174 patients). The primary end point was 30-day mortality. The secondary end point was systemic embolism during treatment. Thirty-day mortality was 18.4%. On univariate analysis, age (64+/-13.9 vs 56.7+/-16.5; P = .01), coma (12.9% vs 2.2%; P = .02), and systemic embolism (71.9% vs 51.4%; P = .048) at presentation were significantly increased among nonsurvivors. Surgical thromboembolectomy had lower mortality than other treatment groups (10.6%; P = .04). In multivariable models, no prognostic factor was a significant independent predictor of mortality. Surgically treated patients had nonsignificantly reduced mortality (odds ratio [OR], 0.65 [0.24-1.72]; P = .65) and thrombolysis-treated patients had increased mortality (OR, 1.62 [0.43-5.97]; P = .47). However, systemic embolism during treatment and combined mortality and systemic embolism was decreased in the surgery group (OR, 0.13 [0.03-0.67]; P = .02 and OR, 0.26 [0.11-0.60]; P = .001). This review attempts to help guide what to do in IPDE, despite severe limitations of the methods. Surgical thromboembolectomy showed a nonsignificant trend toward improved survival, significantly reduced systemic embolism, and composite of mortality and systemic embolism, compared with anticoagulation alone. Thrombolysis, on the other hand, had the opposite effect, although not significantly.
          Article 0 comments Cited 34 times – based on 0 reviews     Review now
            Bookmark
            All references

            Author and article information

            Journal
            Journal ID (nlm-ta): Thorac Cardiovasc Surg Rep
            Journal ID (iso-abbrev): Thorac Cardiovasc Surg Rep
            Journal ID (doi): 10.1055/s-00024355
            Title: The Thoracic and Cardiovascular Surgeon Reports
            Publisher: Georg Thieme Verlag KG (Stuttgart · New York )
            ISSN (Print): 2194-7635
            ISSN (Electronic): 2194-7643
            Publication date (Electronic): 20 August 2015
            Publication date (Print): December 2015
            Volume: 4
            Issue: 1
            Pages: 44-45
            Affiliations
            [1 ]Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
            Author notes
            Address for correspondence Andreas Schaefer, MD University Heart Center Hamburg Martinistraße 52, 20246 HamburgGermany and.schaefer@ 123456uke.de
            Article
            Publisher ID: 150169crc
            DOI: 10.1055/s-0035-1559828
            PMC ID: 4723319
            SO-VID: d090a28a-9586-4b6b-a65f-a3449607c227
            Copyright © © Thieme Medical Publishers
            History
            Date received : 09 May 2015
            Date accepted : 18 June 2015
            Categories
            Subject: Article

            Keywords: cardiovascular surgery,congenital heart disease,echocardiography,heart valve surgery,pulmonary embolism
            Data availability:
            Keywords: cardiovascular surgery, congenital heart disease, echocardiography, heart valve surgery, pulmonary embolism

            Comments

            Comment on this article