He Lu, Xue Jian-Ying, Du Ya-Juan, Xie Xue-Gang, Wang Xing-Ye, Zhang Yu-Shun
Department of Structural Heart Disease, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Cardiovasc Med. 2022 May 20;9:905614. doi: 10.3389/fcvm.2022.905614. eCollection 2022.
We describe a rare case of patent foramen ovale (PFO) associated stroke in a patient with pulmonary embolism, inferior vena cava thrombosis and undergoing filter implantation who successfully underwent PFO closure using the right internal jugular venous approach.
This is a rare case of a 42-year-old patient who presented with stroke and pulmonary embolism and was diagnosed with a PFO, inferior vena cava thrombosis and underwent filter implantation. The patient suffered from stroke and pulmonary embolism successively; that is, embolic events occurred in both the arterial and venous systems. Transesophageal echocardiography (TEE) showed a PFO with an atrial septal aneurysm (ASA), which we considered a "pathological" PFO. Due to the obstructive nature of the inferior vena cava approach, we successfully performed PFO closure via the right internal jugular venous approach under the guidance of X-ray and transthoracic echocardiography (TTE).
The right jugular venous approach provides a simple technical solution for patients who require PFO closure when femoral venous access is unavailable, which can be performed under X-ray and TTE guidance.
我们描述了一例罕见的卵圆孔未闭（PFO）相关卒中病例，患者患有肺栓塞、下腔静脉血栓形成且正在接受滤器植入，该患者通过右颈内静脉途径成功进行了PFO封堵。
这是一例罕见的42岁患者，表现为卒中及肺栓塞，诊断为PFO、下腔静脉血栓形成并接受了滤器植入。患者先后发生卒中及肺栓塞，即动脉和静脉系统均发生了栓塞事件。经食管超声心动图（TEE）显示PFO合并房间隔瘤（ASA），我们认为这是一个“病理性”PFO。由于下腔静脉途径的阻碍性质，我们在X线和经胸超声心动图（TTE）引导下通过右颈内静脉途径成功进行了PFO封堵。
右颈静脉途径为无法获得股静脉通路而需要进行PFO封堵的患者提供了一种简单的技术解决方案，可在X线和TTE引导下进行。
