Skip to main content
SpringerLink
Log in

Surgical embolectomy for paradoxical cerebral embolism with massive pulmonary embolism

  • Case Report
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

The patient was a 68-year-old woman with a history of multiple cerebral emboli. The patient presented with dysarthria, dysphagia, and left facial paralysis. Emergent MRI demonstrated multiple emboli in the brain stem and left occipital lobe. Echocardiography and chest CT demonstrated floating emboli entrapped in the foramen ovale and pulmonary emboli in both main pulmonary arteries. Emergent pulmonary embolectomy and extraction of the emboli on the foramen ovale were successfully performed without neurological exacerbation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Condliffe R, Elliot CA, Hughes RJ, et al. Management dilemmas in acute pulmonary embolism. Thorax. 2013;69:174–80.

    Article  Google Scholar 

  2. Torbicki A, Galié N, Covezzoli A, Rossi E, De Rosa M, Goldhaber SZ, ICOPER Study Group. Right heart thrombi in pulmonary embolism results from the international cooperative pulmonary embolism registry. J Am Coll Cardiol. 2003;41:2245–51.

    Article  Google Scholar 

  3. Wahl A, Jüni P, Mono ML, et al. Long-term propensity score-matched comparison of percutaneous closure of patent foramen ovale with medical treatment after paradoxical embolism. Circulation. 2012;125:803–12.

    Article  Google Scholar 

  4. Rose PS, Punjabi NM, Pearse DB. Treatment of right heart thromboemboli. Chest. 2002;121:806–14.

    Article  Google Scholar 

  5. Fauveau E, Cohen A, Bonnet N, Gacem K, Lardoux H. Surgical or medical treatment for thrombus straddling the patent foramen ovale: impending paradoxical embolism? Report of four clinical cases and literature review. Arch Cardiovasc Dis. 2008;101:637–44.

    Article  Google Scholar 

  6. Dzudovic B, Obradovic S, Rusovic S, et al. Therapeutic approach in patients with a floating thrombus in the right heart. J Emerg Med. 2013;44:e199–205.

    Article  Google Scholar 

  7. Minakawa M, Fukuda I, Miyata H, et al. Outcomes of pulmonary embolectomy for acute pulmonary embolism. Circ J. 2018;82:2184–90.

    Article  Google Scholar 

  8. Myers PO, Bounameaux H, Panos A, Lerch R, Kalangos A. Impending paradoxical embolism. Systematic review of prognostic factors and treatment. Chest. 2010;137:164–70.

    Article  Google Scholar 

  9. Hamon M, Gomes S, Clergeau MR, Fradin S, Morello R, Hamon M. Silent cerebral infarcts in patients with pulmonary embolism and a parent foramen ovale. A prospective diffusion-weighted MRI study. Stroke. 2009;40:3758–62.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan

    Kaoru Hattori, Kazuyuki Daitoku, Satoshi Taniguchi & Ikuo Fukuda

Authors
  1. Kaoru Hattori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuyuki Daitoku
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Satoshi Taniguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ikuo Fukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ikuo Fukuda.

Ethics declarations

Conflict of interest

The authors declare they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 Video 1. Transesophageal echocardiography shows a biatrial embolus entrapped in the patent foramen ovale. (MPG 23298 KB)

Supplementary material 2 Video 2. Intraoperative video. (MPG 18108 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hattori, K., Daitoku, K., Taniguchi, S. et al. Surgical embolectomy for paradoxical cerebral embolism with massive pulmonary embolism. Gen Thorac Cardiovasc Surg 68, 385–388 (2020). https://doi.org/10.1007/s11748-019-01087-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-019-01087-6

Keywords

Search

Navigation