title: Massive pulmonary embolism complicated by a patent foramen ovale with straddling thrombus: report of a case.
abstract: We report a case of massive right pulmonary embolism with a patent foramen ovale and straddling thrombus, occurring a few days after cesarean section in a 31-year-old woman. Preoperatively, a mass was seen echocardiographically in four cardiac cavities. We performed emergency surgery because of the patient's acute hemodynamic deterioration. Intraoperatively, we found a thrombus entrapped in the patent foramen ovale. Most of the thrombus was floating in the right atrium and a long end was found in the left atrium, in addition to the pulmonary emboli. We removed the thrombus, closed the patent foramen ovale by direct suturing, and performed pulmonary embolectomy. Histological examination confirmed thrombi. Doppler examination of the venous system did not reveal any possible source of the thrombus. The patient is now well and free from recurrence of embolic disease 1 year after surgery. We review the literature on this relatively unusual thromboembolic disease.
authors.affiliation: Department of Cardiovascular Surgery, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Erkut
authors.forename: Hikmet
authors.initials: H
authors.lastname: Kocak
authors.forename: Necip
authors.initials: N
authors.lastname: Becit
authors.forename: Huseyin
authors.initials: H
authors.lastname: Senocak
mesh_terms: D000328:Adult; D002585:Cesarean Section; D017128:Embolectomy; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications*; D006801:Humans; D011183:Postoperative Complications; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000209:etiology* / Q000601:surgery; D013927:Thrombosis / Q000150:complications* / Q000601:surgery