Ichimori Yuki, Sakamoto Daisuke, Fuzii Taishi, Nagayoshi Yasuhiro, Ando Makoto, Sakamoto Shigeru, Takano Tamaki
Department of Cardiovascular Surgery, Kanazawa Medical University, Ishikawa, Japan.
Kyobu Geka. 2021 Aug;74(8):587-589.
The patent foramen ovale (PFO) is known as a risk of paradoxical embolism in patients with deep venous thromboses. However, PFO is usually found after systemic embolic symptoms become apparent. A 60-year-old male had complained of dyspnea for two weeks. Ultrasound echocardiography showed a thrombus straddling PFO, and venous echography showed blood clots in the right popliteal and soleus veins. Contrast computed tomography revealed multiple pulmonary embolisms and a thrombus in the right atrium expanding to the left atrium through the atrial septum. The straddling thrombus in the atrium and pulmonary thrombi were extirpated under circulatory arrest with deep hypothermia. An inferior vena cava filter was inserted intravenously four days after surgery. The patient was discharged on the 19th postoperative day without any signs of thromboembolism. Prompt surgery is considered important to prevent thromboembolism in the case of impending paradoxical embolism.
卵圆孔未闭（PFO）被认为是深静脉血栓形成患者发生反常栓塞的一个危险因素。然而，卵圆孔未闭通常是在全身性栓塞症状出现后才被发现。一名60岁男性因呼吸困难两周前来就诊。超声心动图显示有一血栓横跨卵圆孔未闭，静脉超声检查显示右腘静脉和比目鱼肌静脉内有血凝块。对比计算机断层扫描显示多发性肺栓塞以及右心房内有一血栓通过房间隔扩展至左心房。在深度低温循环停止的情况下，切除了心房内横跨的血栓和肺血栓。术后四天经静脉插入下腔静脉滤器。患者术后第19天出院，无任何血栓栓塞迹象。对于即将发生反常栓塞的情况，及时手术被认为对于预防血栓栓塞很重要。
