RESUMEN
Abstract: Patent Foramen Ovale (PFO) is one of the most frequent congenital defects in adults. Its prevalence in middle-aged adults is close to 25-30% and may cause paradoxical embolic phenomena. We report a 45 years old male admitted for an ischemic stroke with an occlusion of the left terminal internal carotid artery. A thrombectomy was performed. Searching for possible sources of emboli, a patent foramen ovale was detected in an echocardiography, with an hypoechogenic examination image passing through it. Anticoagulant therapy was started and the patient had an uneventful evolution.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Embolia Paradójica/etiología , Foramen Oval Permeable/complicaciones , Ecocardiografía , Arterias Carótidas , Factores de Riesgo , Resultado del Tratamiento , Trombectomía/métodos , Embolia Paradójica/cirugía , Embolia Paradójica/diagnóstico por imagen , Accidente Cerebrovascular/etiología , Foramen Oval Permeable/diagnóstico por imagenRESUMEN
We report a 63 year-old female with a pulmonary embolism in whom echocardiography revealed the presence ofríght heart thrombus. A section ofthis thrombus was entrapped in a patent foramen oval and floating in both atria. This rare situation, named impending paradoxical embolism, prompted us to perform a surgical intervention, removing the thrombus andrepairing the foramen ovale.
Asunto(s)
Anciano , Femenino , Humanos , Embolia Paradójica , Foramen Oval Permeable , Embolia Pulmonar , Trombosis , Ecocardiografía Transesofágica , Embolia Paradójica/cirugía , Foramen Oval Permeable/cirugía , Embolia Pulmonar/cirugía , Trombosis/cirugíaRESUMEN
La presencia de un trombo venoso atrapado en un defecto interauricular e insinuándose en las cavidades izquierdas configura una forma extremadamente inusual de enfermedad tromboembólica denominada embolia paradojal inminente. Presentamos el caso de un varón de 71 años, sometido 10 días antes a adenomectomía prostática, que consultó por disnea y mareos. Se le diagnosticó tromboembolismo pulmonar bilateral por tomografía axial computada helicoidal. Se lo anticoaguló con heparina sódica y se le realizó un ecocardiograma transesofágico que mostró un trombo que atravesaba el foramen oval y se alojaba en la aurícula izquierda. No presentaba signos clínicos de embolización sistémica. Se realizó la embolectomía quirúrgica y cierre del defecto auricular. El paciente falleció
An intracardiac thrombus traversing a patent foramen ovale is a very infrequent but potentially catastrophic complication of the thromboembolic disease. It is named "impending paradoxical embolism". We report the case of a 71 year old Caucasian male warded in ten days after a prostatectomy because of bilateral pulmonary embolism. Diagnosis was confirmed by HCT scan and the patient received anticoagulation with heparin. A transesophageal ecocardiogram disclosed a thrombus traversing foramen ovale into the left atrium. Surgical embolectomy was performed, but the patient died shortly after surgery