A traveler in transit: A case of an impending thrombus entrapped in a patent foramen ovale.

Thrombus across a patent foramen ovale (PFO), also referred to as a pending paradoxical embolus is a rare condition. We report a case of a 50-year-old male taxi driver who was diagnosed with a massive saddle pulmonary embolism, leg deep venous thromboembolism, and pending paradoxical embolus through a PFO with systemic embolization. The patient had an inferior vena cava (IVC) filter inserted immediately followed by surgical thromboembolectomy and closure of PFO. He was discharged home 1 month after surgery. Surgery is the treatment of choice for preventing systemic embolization particularly cryptogenic stroke and its sequelae from pending paradoxical embolus. Preoperative IVC filter is a useful adjunct to prevent ongoing thromboembolism in the perioperative period. The case report presented at the Annual Cardiothoracic Meeting, 10 November 2017, Royal Society of Medicine, London.