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Case Reports
. 2016 Fall;16(3):321-3.

Thromboembolism-in-Transit and Patent Foramen Ovale: Should Screening Echocardiogram Be Routine for Thromboembolic Disease?

Dawn S Hui  1 , Fernando Fleischman  2 , P Michael McFadden  2
Affiliations
Case Reports

Thromboembolism-in-Transit and Patent Foramen Ovale: Should Screening Echocardiogram Be Routine for Thromboembolic Disease?

Dawn S Hui et al. Ochsner J. 2016 Fall.

Abstract

Background: Thromboembolism-in-transit straddling a patent foramen ovale (PFO) is a rare condition that requires urgent surgical intervention to prevent arterial emboli.

Case report: We present the case of a 42-year-old female who presented with a symptomatic pulmonary embolism. Echocardiography identified a PFO, with a bridging thrombus-in-transit and evidence of right ventricular strain. Urgent surgery was performed because of the risk of systemic embolism. A large thrombus was identified during biatrial exploration. Pulmonary embolectomy and primary PFO closure were performed.

Conclusion: Because of the 20%-30% incidence of PFOs in the general population, we suggest that echocardiography should be considered for routine surveillance in thromboembolism because of the risk of systemic sequelae.

Keywords: Echocardiography; foramen ovale–patent; thromboembolism.

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Figures

Figure 1.
Figure 1.
Short-axis echocardiographic view demonstrates a large thromboembolism-in-transit across a patent foramen ovale (PFO).
Figure 2.
Figure 2.
Intraoperative photograph of the extracted thrombus.
See this image and copyright information in PMC

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