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Eur J Cardiothorac Surg 1998;14:624-628
© 1998 Elsevier Science NL

Review article

Diagnosis and management of entrapped embolus through a patent foramen ovale

Department of Cardiothoracic and Vascular Surgery and Angiology, Dupuytren University Hospital, 2 Ave Martin Luther King, 87042 Limoges, France

Received 25 May 1998; received in revised form 28 September 1998; accepted 6 October 1998.

Corresponding author.

The diagnosis of impending paradoxical embolus by echocardiography is exceptional and its management remains unclear. Through a personal case, we performed an exhaustive review of the medical literature of this rare finding. Since the first report, only 43 cases have ever been reported. The superiority of transesophageal echocardiography is underlined. The clinical features are complex. The classical simultaneous pulmonary and paradoxical embolism is often absent. Therapeutic options are cardiac surgery, thrombolysis or anticoagulation. The early mortality rate is high (21%). In addition, recurrent embolisms are reported when a medical treatment is chosen. The cumulative results of each possibility are described.

Key Words: Echocardiography • Embolism • Foramen ovale

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