title: Right-to-left interatrial shunt with hypoxemia caused by a right atrial thrombus.
abstract: A right-to-left shunt in the presence of normal pulmonary artery pressure is an unusual cause of hypoxemia in an adult who has a patent foramen ovale. We report a rare case of such a shunt-the result of a right atrial thrombus that formed in a hypercoagulable patient after placement of an indwelling central venous catheter for chemotherapy. In order to ascertain the nature of the right atrial mass and to decrease the risk of systemic embolization, the thrombus was surgically removed with the patient on cardiopulmonary bypass.
authors.affiliation: Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
authors.forename: Franco
authors.initials: F
authors.lastname: Vargas-Beal
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Coulter
authors.forename: Sai
authors.initials: S
authors.lastname: Yendamuri
authors.forename: Ariadna
authors.initials: A
authors.lastname: Contreras
authors.forename: J Michael
authors.initials: JM
authors.lastname: Duncan
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001794:Blood Pressure; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003326:Coronary Circulation; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D000860:Hypoxia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020151:Protein C Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011651:Pulmonary Artery / Q000503:physiopathology; D017131:Thrombectomy; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin