Impending Paradoxical Embolism across a Patent Foramen Ovale: Case Report

2005 ◽  
Vol 8 (1) ◽  
pp. 47 ◽  
Author(s):  
Minoo N. Kavarana ◽  
Todd Boice ◽  
Laman A. Gray
Keyword(s):  
Patent Foramen Ovale ◽  
Inferior Vena ◽  
Vena Cava ◽  
Protein S ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
S Deficiency ◽  
Warfarin Treatment ◽  
Deep Vein ◽  
Work Up

We describe a case of impending paradoxical embolism in a 43-year-old male patient with pulmonary embolism. Transesophageal echocardiography revealed a thromboembolus straddling a patent foramen ovale. The patient underwent emergency removal of the intracardiac clot with closure of the patent foramen ovale. A postoperative work-up for a hypercoagulable state revealed a protein-S deficiency and bilateral lower extremity deep vein thromboses. A Greenfield inferior vena cava filter was inserted, anticoagulation was performed, and warfarin treatment was continued after the patient was discharged home.

scholarly journals Patent foramen ovale closure in a patient with vena cava filter: a case report

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Pierluigi Omedè ◽  
Pier Paolo Bocchino ◽  
Ovidio De Filippo ◽  
Fabrizio D’Ascenzo
Keyword(s):  
Inferior Vena Cava ◽  
Patent Foramen Ovale ◽  
Interventional Procedures ◽  
Inferior Vena ◽  
Vena Cava ◽  
Delivery Systems ◽  
Foramen Ovale ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Pfo Closure

Abstract Background The presence of a patent foramen ovale (PFO) is associated with several medical conditions, including cryptogenic left circulation thromboembolism. PFO closure was demonstrated to reduce recurrent ischaemic stroke in patients with prior cryptogenic stroke. The presence of an inferior vena cava filter (IVCF), however, may impede a transfemoral PFO closure procedure. Case summary We describe the case of a 50-year-old man with a PFO suffering from ischaemic stroke from paradoxical thromboembolism originating from deep vein thrombosis and requiring an IVCF. After deep vein thrombosis resolution, due to the high risk of stroke recurrences, the patient was recommended PFO closure. IVCF retrieval by the interventional radiologist was first attempted but failed. A transfemoral PFO closure procedure was thus endeavoured with the IVCF in place and was successful. The patient was then discharged in good clinical status and no stroke recurrences were reported at 5 months follow-up. Discussion Albeit an IVCF provides benefit in patients with recurrent thromboembolic events despite adequate anticoagulation therapy, its presence may hinder interventional procedures necessitating delivery systems to advance through the inferior vena cava. We reported on a successful PFO closure procedure via a femoral venous access in a patient with an IVCF in place, thus demonstrating the feasibility of advancing delivery systems through an IVCF. As interventional procedures requiring the advancement of delivery systems through the inferior vena cava are becoming increasingly common, the feasibility of IVCF crossing with catheters and delivery systems alike paves the way for novel interventional possibilities.

scholarly journals Platypnea-orthodeoxia syndrome after open prostatectomy and cystolithotomy: Coincidence or unknown pathophysiology?

2020 ◽  
Vol 8 ◽  
pp. 2050313X2090459
Author(s):  
Ismael P Flores ◽  
Alexandre T Maciel
Keyword(s):  
Case Report ◽  
Patent Foramen Ovale ◽  
Inferior Vena ◽  
Vena Cava ◽  
Sitting Position ◽  
Foramen Ovale ◽  
Open Prostatectomy ◽  
Anatomical Changes ◽  
Upper Abdominal ◽  
Cardiac Shunt

A few cases of platypnea-orthodeoxia syndrome have been described in the literature, some of them after thoracic or upper abdominal surgeries. In most cases, hypoxemia in the upright or sitting position, which is the main clinical symptom for this uncommon diagnosis, is usually related to a dynamic right to left cardiac shunt induced by anatomical changes in the relative position between the inferior vena cava and the atria in the presence of a patent foramen ovale. In this case report, we describe a situation in which platypnea-orthodeoxia syndrome developed acutely before surgery but that became severely exacerbated after an open urologic surgery without a clear acute anatomical change that could be responsible for triggering the syndrome. This case might suggest that the pathophysiology of acute platypnea-orthodeoxia syndrome is not completely elucidated and that other possible triggers for acute clinical manifestation in addition to acute anatomical thoracic changes must be explored.

scholarly journals Patent Foramen Ovale Closure for Splenic Infarction: An Unusual Presentation and an Unusual Indication

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Edgar Stroppa Lamas ◽  
Alan Vinicius Gamero Osti
Keyword(s):  
Abdominal Pain ◽  
Clinical Condition ◽  
Patent Foramen Ovale ◽  
Rare Case ◽  
Acute Abdominal Pain ◽  
Paradoxical Embolism ◽  
Splenic Infarction ◽  
Foramen Ovale ◽  
Case Presentation ◽  
Work Up

Background. Splenic infarction is a rare clinical condition. It is generally attributed to hematologic, vascular, cardioembolic, and infectious diseases or trauma. Case Presentation. We describe a rare case in an otherwise asymptomatic 41-year-old overweight woman with acute abdominal pain. Imaging work-up revealed splenic infarction. Common etiologies were excluded. A transesophageal echocardiography (TEE) revealed a patent foramen ovale (PFO). The patient was sent to closure with good outcome. Conclusion. Paradoxical embolism due to PFO can be a cause of splenic infarction, and its investigation and subsequent closure may be considered when there are no other causative disorders.

scholarly journals Multiorgan paradoxical embolism in an elderly female with a patent foramen ovale: a case report

2019 ◽  
Vol 92 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Dimitrios Anyfantakis ◽  
Paraskevi Karona ◽  
Pagona Kastanaki ◽  
Athanasios Kourakos ◽  
Miltiades Kastanakis
Keyword(s):  
Patent Foramen Ovale ◽  
Arterial Occlusion ◽  
Systemic Circulation ◽  
Paradoxical Embolism ◽  
Adverse Outcomes ◽  
Current Evidence ◽  
Foramen Ovale ◽  
Vein Thrombosis ◽  
Initiation Of Therapy ◽  
Deep Vein

Paradoxical embolism is an uncommon cause of arterial occlusion with a high mortality burden. Current evidence suggests that patent foramen ovale is the most important etiological factor of paradoxical embolism, by acting as a pathway for a thromboembolic material originating from the peripheral veins, passing through the lungs and entering the systemic circulation. Here we present a case of paradoxical embolism in the mesenteric and renal arteries associated with pulmonary embolism and deep vein thrombosis in an elderly woman with no predisposing risk factor. A diagnosis of paradoxical embolism was considered and the presence of a patent foramen ovale was consequently confirmed with a transesophageal echocardiography. Urgent thrombolysis saved the life of the patient. Paradoxical embolism represents an emergency and therefore prompt diagnosis and initiation of therapy may prevent adverse outcomes.

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