Sarah Dunn, Nisha Dave, Yiliam F Rodriguez-Blanco, Oscar Aljure
Department of Anesthesiology, Jackson Memorial Hospital, Miami, FL, USA
A 58-year-old male presented with a hemodynamically significant pulmonary embolism. Computed tomography angiogram revealed a saddle embolus in the main pulmonary artery with extensive clot burden affecting all lobes and right heart strain. Transthoracic echocardiogram displayed a dilated right ventricle with reduced systolic function. The patient was scheduled for pulmonary embolectomy. The intraoperative transesophageal echocardiogram (TEE) demonstrated a mobile left atrial thrombus that was missed on previous imaging. After removal of the thrombi, TEE showed a patent foramen ovale (PFO). The left atrial thrombus passed across the PFO secondary to increased right heart and pulmonary pressures.
7728 Abbott Ave. Unit 301, Miami Beach, FL 33141
Source of Support: None, Conflict of Interest: None
[FULL TEXT] [PDF]*