Top

General Thoracic and Cardiovascular Surgery

Published in:

01-04-2020 | Stroke | Case Report

Surgical embolectomy for paradoxical cerebral embolism with massive pulmonary embolism

Authors: Kaoru Hattori, Kazuyuki Daitoku, Satoshi Taniguchi, Ikuo Fukuda

Published in: General Thoracic and Cardiovascular Surgery | Issue 4/2020

Abstract

The patient was a 68-year-old woman with a history of multiple cerebral emboli. The patient presented with dysarthria, dysphagia, and left facial paralysis. Emergent MRI demonstrated multiple emboli in the brain stem and left occipital lobe. Echocardiography and chest CT demonstrated floating emboli entrapped in the foramen ovale and pulmonary emboli in both main pulmonary arteries. Emergent pulmonary embolectomy and extraction of the emboli on the foramen ovale were successfully performed without neurological exacerbation.

Available only for authorised users

Condliffe R, Elliot CA, Hughes RJ, et al. Management dilemmas in acute pulmonary embolism. Thorax. 2013;69:174–80.CrossRef

Torbicki A, Galié N, Covezzoli A, Rossi E, De Rosa M, Goldhaber SZ, ICOPER Study Group. Right heart thrombi in pulmonary embolism results from the international cooperative pulmonary embolism registry. J Am Coll Cardiol. 2003;41:2245–51.CrossRef

Wahl A, Jüni P, Mono ML, et al. Long-term propensity score-matched comparison of percutaneous closure of patent foramen ovale with medical treatment after paradoxical embolism. Circulation. 2012;125:803–12.CrossRef

Rose PS, Punjabi NM, Pearse DB. Treatment of right heart thromboemboli. Chest. 2002;121:806–14.CrossRef

Fauveau E, Cohen A, Bonnet N, Gacem K, Lardoux H. Surgical or medical treatment for thrombus straddling the patent foramen ovale: impending paradoxical embolism? Report of four clinical cases and literature review. Arch Cardiovasc Dis. 2008;101:637–44.CrossRef

Dzudovic B, Obradovic S, Rusovic S, et al. Therapeutic approach in patients with a floating thrombus in the right heart. J Emerg Med. 2013;44:e199–205.CrossRef

Minakawa M, Fukuda I, Miyata H, et al. Outcomes of pulmonary embolectomy for acute pulmonary embolism. Circ J. 2018;82:2184–90.CrossRef

Myers PO, Bounameaux H, Panos A, Lerch R, Kalangos A. Impending paradoxical embolism. Systematic review of prognostic factors and treatment. Chest. 2010;137:164–70.CrossRef

Hamon M, Gomes S, Clergeau MR, Fradin S, Morello R, Hamon M. Silent cerebral infarcts in patients with pulmonary embolism and a parent foramen ovale. A prospective diffusion-weighted MRI study. Stroke. 2009;40:3758–62.CrossRef

Title: Surgical embolectomy for paradoxical cerebral embolism with massive pulmonary embolism
Authors: Kaoru Hattori
Kazuyuki Daitoku
Satoshi Taniguchi
Ikuo Fukuda
Publication date: 01-04-2020
Publisher: Springer Singapore
Keywords: Stroke
Dysarthria
Published in: General Thoracic and Cardiovascular Surgery / Issue 4/2020
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-019-01087-6

At a glance: The STEP trials

Springer Medicine

Surgical embolectomy for paradoxical cerebral embolism with massive pulmonary embolism

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2020

Surgical management of peripheral pulmonary artery pseudoaneurysm

Acquired intercostal lung herniation: conservative management may lead to continuation of symptoms and other adverse consequence

Mitral valve replacement and trans-mitral myectomy for a child with Noonan syndrome accompanied by hypertrophic obstructive cardiomyopathy

Neovascularization in pericarditis: a possible etiology of hemopericardium

Investigation of displaced bronchi using multidetector computed tomography: associated abnormalities of lung lobulations, pulmonary arteries and veins

Surgical treatment of single and multiple thymoma recurrences