Double-edged sword in the heart

Abstract

Trapped thrombus in a patent foramen ovale is a rare condition. Echocardiography is the main tool for diagnosis and for determination of the treatment to choose. There are a number of treatment options for trapped deep venous thrombus in a patent foramen ovale, including surgical thrombectomy, thrombolytics, and anticoagulant therapy. All patients should be evaluated individually, because the systemic and pulmonary thromboembolism risk of all treatment options is like a 'double-edged sword'. Here, we report a case of a patient with trapped thrombus in the patent foramen ovale detected by echocardiography, and successfully treated with surgical thrombectomy under extracorporeal circulation.

Un trombo atrapado en el foramen oval patente: un migrante fuera de lo ordinario

“…Patent foramen ovale (PFO) is the most associated congenital heart defect. If the thrombus is larger than the foramen, an even rarer condition can arise, an impending paradoxical embolism (IPE) 2 . With a high mortality rate, the management requires emergency intervention to prevent systemic embolization 3 .…”