Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.
Ann Card Anaesth. 2021 Oct-Dec;24(4):476-478. doi: 10.4103/aca.ACA_186_20.
Although a patent foramen ovale (PFO) is relatively common, confirmed reports of thrombus entrapped within a PFO are uncommon. Management of impending paradoxical embolism (IPE), also called a thrombus in transit, lacks consensus but includes systemic anticoagulation (e.g., heparin), systemic thrombolysis, or surgical thrombectomy. We present a case of IPE diagnosed with intraoperative transesophageal echocardiography (TEE) as well as a novel en bloc approach to atrial septal aneurysmectomy to minimize embolism and facilitate repair of the interatrial septum. Timely use of intraoperative TEE may aid in diagnosis and help guide the surgical approach to minimize embolic risk with an IPE.
尽管卵圆孔未闭（PFO）相对常见，但确认有血栓被困在 PFO 内的报告并不常见。即将发生的矛盾性栓塞（IPE），也称为正在转移的血栓，其管理尚无共识，但包括全身抗凝（如肝素）、全身溶栓或手术血栓切除术。我们报告了一例术中经食管超声心动图（TEE）诊断的 IPE 病例，以及一种新的整体方法用于房间隔瘤切除术，以最大程度地减少栓塞并促进房间隔的修复。术中 TEE 的及时使用可能有助于诊断，并有助于指导手术方法，以最大程度地降低 IPE 的栓塞风险。
