Acute Lethal Stroke Affecting All Brain-Supplying Cerebral Arteries due to Paradoxical Embolism through a Patent Foramen ovale

Heckmann, Josef G.; Handschu, René; Huk, W.; Neundörfer, B.

doi:10.1159/000016051

Cited by 2 publications

(2 citation statements)

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“…Under favourable conditions, a PFO may allow the 'escape' of a thrombus into the arterial system where it can be removed by surgical manoeuvres. In unfavourable cases, however, the escaped thrombembolic material may obliterate the cerebral vessels with fatal consequences [5]. As in patients with both PFO and atrial septal aneurysm, the risk of recurrent cerebrovascular events is fourfold higher than in patients with PFO alone and risk of major pulmonary embolism is rather small, preventive strategies such as anticoagulation other than aspirin or PFO closure should be considered [12].…”

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Patent foramen ovale as lifesaving purging valve

Heckmann

Wasmeier

Dütsch

et al. 2006

European Journal of Emergency Medicine

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Patent foramen ovale is considered as a potential risk factor for stroke owing to paradoxic embolism, leading to the question "to close or not to close the patent foramen ovale". We report a 26-year-old woman with chest pain, dyspnoea, sudden severe pain in both legs and paraplegia. Thoracic and abdominal computed tomography revealed massive pulmonary embolism and complete obstruction of the abdominal aorta. Interventional removal of the aortic thrombus was undertaken using the Fogarty catheter technique via the femoral arterial approach. As a result of worsening of cardiopulmonary function during the procedure, additional local thrombolysis, with a total of 50 mg recombinant tissue plasminogen activator, and fragmentation of the thrombus in the right pulmonary artery were performed via a femoral vein approach. Ultrasound studies revealed a patent foramen ovale of about 12 mm diameter with a significant right to left shunt. Under favourable conditions, a patent foramen ovale may allow the escape of a thrombus, sufficient to cause a potentially fatal pulmonary embolism, into the arterial system, where it can be removed by interventional manoeuvres.

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Section: Case Reportmentioning

confidence: 99%

“…In recent years, patent foramen ovale (PFO) has gained increasing attention as a potential risk factor for stroke via the mechanism of paradoxical embolism [1][2][3][4][5][6]. A prerequisite is that thrombotic material embolizes from the venous system to the right heart.…”

Section: Introductionmentioning

confidence: 99%