Surgical treatment of a massive bilateral pulmonary embolus due to an entrapped thrombus in a patent foramen ovale: a case report.

INTRODUCTION: Entrapped thrombus in a patent foramen ovale is a rare form of right heart thromboembolism. Various treatments have been used, such as anti-coagulation and thrombolytic therapy, vena cava filter, percutaneous thrombectomy and surgical embolectomy. CASE PRESENTATION: A 60-year-old Kosovan woman was admitted to our hospital with a massive bilateral pulmonary thromboembolism, entrapped thrombus in the patent foramen ovale and severe right ventricular dysfunction. The patient underwent on-pump beating-heart removal of the intracardiac thrombus and bilateral pulmonary embolectomy with the use of a Fogarty catheter. The patient's post-operative course was uneventful. In this report, we describe for the first time in this pathology, to the best of our knowledge, a surgical strategy that seems to offer an excellent outcome in patients with severe right ventricular dysfunction. CONCLUSIONS: The chosen surgical technique, consisting of on-pump open beating-heart surgery, is a unique procedure in the treatment of an acute pulmonary thromboembolism and entrapped thrombus in a patent foramen ovale.

Entrapped thrombus in a foramen ovale causing pulmonary emboli treated with emergent surgery. Literature review.

A 60-year-old woman was admitted due to massive bilateral pulmonary thromboembolism and entrapped thrombus in the patent foramen ovale and severe right ventricular dysfunction. The patient underwent on-pump/beating heart removal of the intracardiac thrombus and bilateral pulmonary embolectomy. The postoperative course was uneventful. The chosen surgical strategy seems to offer excellent outcome in patients with severe right ventricular dysfunction.