d'Audiffret A, Shenoy S S, Ricotta J J, Dryjski M
Department of Surgery, SUNY at Buffalo, New York, USA.
Cardiovasc Surg. 1998 Jun;6(3):302-6. doi: 10.1016/s0967-2109(97)00154-3.
Paradoxical emboli are considered a rare event, representing less than 2% of all arterial emboli. The most common intracardiac defect associated with paradoxical emboli is a patent foramen ovale. Most commonly, a pulmonary embolism is the cause of the acute increase in right atrial pressure leading to a reversal of intracardiac flow and passage of venous embolic material to the left heart. We present a patient with a pulmonary embolism and paradoxical emboli, and discuss therapeutic approach. We suggest that the treatment of choice for the patient with pulmonary embolism and non-limb-threatening acute ischemia due to a paradoxical emboli should be thrombolytic therapy and intracaval filter placement, followed by patent foramen ovale repair.
反常栓塞被认为是一种罕见事件，占所有动脉栓塞的比例不到2%。与反常栓塞相关的最常见心脏内缺损是卵圆孔未闭。最常见的情况是，肺栓塞是右心房压力急性升高的原因，导致心内血流逆转以及静脉栓子物质进入左心。我们报告一例患有肺栓塞和反常栓塞的患者，并讨论治疗方法。我们建议，对于因反常栓塞导致肺栓塞和非肢体威胁性急性缺血的患者，治疗选择应为溶栓治疗和下腔静脉滤器置入，随后进行卵圆孔未闭修复。
