Eur J Cardiothorac Surg 2006;29:249
© 2006 Elsevier Science NL
Images in cardio-thoracic surgery |
Impending paradoxical embolus early post-coronary surgery
Alexander Kulik
a
,
*
,
Ian G. Burwash
b
,
John P. Veinot
c
,
Roy G. Masters
a
a Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Suite H3201, Ottawa, Ont., Canada K1Y 4W7
b Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ont., Canada
c Division of Anatomical Pathology, University of Ottawa Heart Institute, Ottawa, Ont., Canada
Received 11 November 2005;
accepted 21 November 2005.
* Corresponding author. Tel.: +1 613 761 4233; fax: +1 613 761 5217. (Email: akulik{at}ottawaheart.ca).
Key Words: Thromboembolism • Echocardiography • Surgery complications
A 74-year-old male presented with dyspnea 2 weeks post-CABG. Echocardiography demonstrated an impending paradoxical embolus. A large mobile serpiginous thrombus traversed a PFO and prolapsed across the mitral valve into the left ventricle during diastole (Fig. 1
). At the time of emergency surgery, a 12 cm friable organizing thrombus was removed (Fig. 2
).
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Fig. 1. Echocardiography demonstrating the mobile impending paradoxical embolus straddling the atrial septum (top) in the left atrium (middle). The thrombus prolapsed into the left ventricle during diastole (bottom) [LA = left atrium, LV = left ventricle, RA = right atrium, RV = right ventricle].
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