A Surgical Case of Trapped Thrombus in a Patent Foramen Ovale with Suspicion of Paradoxical Embolism

スポンサーリンク

概要

• 論文の詳細を見る

• A 78-year-old woman complaining of suddenly developed numbness and coldness of the left hand was referred to our hospital on the suspicion of embolism. A 2×1cm mass was revealed in the fossa ovalis of the interatrial septum by echocardiography. She underwent operation under a preoperative diagnosis of thrombus in the left atrium or tumor of the interatrial septum. In the operation, the mass was excised including the interatrial septum and the defect of the interatrial septum was closed with a PTFE patch. A sagittal section of the mass showed that it was a fresh thrombus covered with normal endocardium of the fossa ovalis except for a small protrusion to the left atrial cavity. These findings yielded diagnosis of thrombus trapped in a patent foramen ovale. She was discharged after an uneventful postoperative course, although temporary pacing was needed for transient bradycardia in the early postoperative days. In this case, we hypothesize that an unidentified venous thrombus trapped in a patent foramen ovale had partly passed through the interatrial septum and caused paradoxical embolism in the left hand. Paradoxical embolism is a well-known phenomenon described in a number of reports. There are some reports of a trapped thrombus in a patent foramen ovale detected by echocardiography or in autopsy. We describe a rare case of surgical demonstration of a trapped thrombus in a patent foramen ovale, and recommend that examinations for venous thrombus with a suspicion of paradoxical embolism are necessary for patients of thromboembolism.

• 特定非営利活動法人 日本心臓血管外科学会の論文

特定非営利活動法人 日本心臓血管外科学会 | 論文

• 慢性静脈不全症に対する深部静脈逆流遮断手術 弁形成術と弁置換術
• 高令者(70才以上)の腹部大動脈外科の検討
• 大腿吻合部動脈瘤の発生原因の検討
• High riskの潜在性凝固異常と腹部大動脈瘤手術
• Aorto-femoro-poplitealの広汎閉塞に対する2期的再建法の工夫

もっと見る

スポンサーリンク