title: Surgical treatment of a massive bilateral pulmonary embolus due to an entrapped thrombus in a patent foramen ovale: a case report.
abstract: BACKGROUND
  Entrapped thrombus in a patent foramen ovale is a rare form of right heart thromboembolism. Various treatments have been used, such as anti-coagulation and thrombolytic therapy, vena cava filter, percutaneous thrombectomy and surgical embolectomy.
  
  
  METHODS
  A 60-year-old Kosovan woman was admitted to our hospital with a massive bilateral pulmonary thromboembolism, entrapped thrombus in the patent foramen ovale and severe right ventricular dysfunction. The patient underwent on-pump beating-heart removal of the intracardiac thrombus and bilateral pulmonary embolectomy with the use of a Fogarty catheter. The patient's post-operative course was uneventful. In this report, we describe for the first time in this pathology, to the best of our knowledge, a surgical strategy that seems to offer an excellent outcome in patients with severe right ventricular dysfunction.
  
  
  CONCLUSIONS
  The chosen surgical technique, consisting of on-pump open beating-heart surgery, is a unique procedure in the treatment of an acute pulmonary thromboembolism and entrapped thrombus in a patent foramen ovale.
authors.affiliation: Division of Cardiac Surgery, University Hospital Center of Tirana, Tirana, Albania. edvinprifti@hotmail.com.
authors.forename: Edvin
authors.initials: E
authors.lastname: Prifti
authors.affiliation: Division of Heart Disease, Gjakova Hospital, Rr Prizren, Gjakove, Kosovo. fadilademaj-kosove@hotmail.com.
authors.forename: Fadil
authors.initials: F
authors.lastname: Ademaj
authors.affiliation: Division of Cardiac Surgery, University Hospital Center of Tirana, Tirana, Albania. arbenbaboci@hotmail.com.
authors.forename: Arben
authors.initials: A
authors.lastname: Baboci
authors.affiliation: Division of Cardiac Surgery, University Hospital Center of Tirana, Tirana, Albania. adoko@yahoo.com.
authors.forename: Albana
authors.initials: A
authors.lastname: Doko
authors.affiliation: Division of Heart Disease, Gjakova Hospital, Rr Prizren, Gjakove, Kosovo. dan.teferici@gmail.com.
authors.forename: Daniela
authors.initials: D
authors.lastname: Teferici
mesh_terms: D006348:Cardiac Surgical Procedures; D017548:Echocardiography, Transesophageal; D017128:Embolectomy / Q000379:methods*; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000601:surgery*; D013927:Thrombosis / Q000150:complications; D018497:Ventricular Dysfunction, Right / Q000209:etiology