title: Three-dimensional transesophageal echocardiography of a thrombus entrapped by a patent foramen ovale.
abstract: The substrate of paradoxic embolization is a patent foramen ovale allowing right-to-left passage of embolic material. A thrombus in transit entrapped by a patent foramen straddling an atrial septal aneurysm is an exceedingly transient condition rarely documented on imaging studies. We present the case of a 67-year-old man with acute pulmonary embolism and concomitant cerebral infarction found to have a large thrombus traversing a patent foramen ovale. Intraoperative real-time three-dimensional transesophageal echocardiography allowed accurate spatial characterization of the thrombus and correlated closely with surgical findings. It provided more realistic intraoperative guidance compared with conventional two-dimensional transesophageal echocardiography.
authors.affiliation: Division of Cardiology, University of Minnesota Medical Center, Minneapolis, Minnesota 55455, USA.
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Sattiraju
authors.forename: S Carolina
authors.initials: SC
authors.lastname: Masri
authors.forename: Kenneth
authors.initials: K
authors.lastname: Liao
authors.forename: Emil
authors.initials: E
authors.lastname: Missov
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods*; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006325:Heart Atria; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D015203:Reproducibility of Results; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery