title: Intraoperative identification of both a paradoxical embolism and its probable etiologic site.
abstract: We report a case of upper extremity arterial ischemia in a 41-year-old man. Intraoperative transesophageal echocardiography identified a paradoxical embolization that traversed a patent foramen ovale as the probable etiology. The diagnosis of paradoxical embolism with intraoperative identification of the etiologic site of the deep venous thrombosis is a rare event. This case presents the use of transesophageal echocardiography beyond its monitoring function in helping diagnose the cause of arterial ischemia.
authors.affiliation: Department of Anesthesiology, Medical University of Ohio, Toledo, OH 43614, USA.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Casabianca
authors.forename: Shashi B
authors.initials: SB
authors.lastname: Bhatt
authors.forename: Jesse G
authors.initials: JG
authors.lastname: Lopez
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Morgos
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Papadimos
mesh_terms: D000328:Adult; D001132:Arm / Q000098:blood supply; D017548:Echocardiography, Transesophageal; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging* / Q000209:etiology; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery; D008297:Male; D016343:Monitoring, Intraoperative; D011655:Pulmonary Embolism / Q000209:etiology / Q000628:therapy; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy